Lavette Quintana, LISW

Individual provider Active NPI Case Manager/Care Coordinator · Bloomfield, NM

NPI 1356775449 · NPPES record last updated Aug 26, 2013

Key facts

NPI
1356775449
Entity type
Individual (NPI type 1)
Primary specialty
Case Manager/Care Coordinator 171M00000X
License
356171 (NM)
Practice address
404 N Frontier St
Bloomfield, NM 87413-5528
Phone
(505) 948-2459
NPI assigned
Aug 26, 2013
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
356171NMMDCase Manager/Care Coordinator

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X 356171 NM Yes

Addresses

Primary practice location

404 N Frontier St
Bloomfield, NM 87413-5528

Mailing address

404 N Frontier St
Bloomfield, NM 87413-5528
Phone (505) 948-2459

Other providers in Bloomfield, NM

All providers in Bloomfield, NM · Case Manager/Care Coordinator in New Mexico

Sources for this page

Verify at the official NPI Registry.