MEDICARE: BRANDI JAURE LMSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041S0200X	School Social Worker	M-10607	NM

General Provider Information

NPI Number	:	1487265849
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRANDI JAURE LMSW

Provider Business Mailing Address
First Line	:	838 W HESTER ST
Second Line	:
City	:	SILVER CITY
State	:	NM
Zip	:	88061-4316
Country	:	US
Telephone Number	:	575-313-9802
Fax Number	:

Provider Business Practice Location Address
First Line	:	4042 HIGHWAY 90 S
Second Line	:
City	:	SILVER CITY
State	:	NM
Zip	:	88061-9172
Country	:	US
Telephone Number	:	575-956-2170
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/11/2020
Last Update Date	:	08/11/2020

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Directions to “ BRANDI JAURE LMSW” Practice Location

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