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NPI Code Detail

MEDICARE: JULIE CHAVEZ MSW

MEDICARE: JULIE CHAVEZ MSW
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
1104100000XSocial WorkerB-09357NM

General Provider Information

NPI Number : 1871158642
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULIE CHAVEZ MSW
Provider Business Mailing Address
First Line : PO BOX 677
Second Line :
City : SILVER CITY
State : NM
Zip : 88062-0677
Country : US
Telephone Number : 575-388-2414
Fax Number : 575-590-3041
Provider Business Practice Location Address
First Line : 1120 N WEST ST
Second Line :
City : SILVER CITY
State : NM
Zip : 88061-4600
Country : US
Telephone Number : 575-388-2414
Fax Number : 575-388-2457
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/07/2019
Last Update Date : 05/07/2019

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