BRENT LANE CLOVIS

SANTA FE, NM
NPI1962686915
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy104100000X Social Worker
(Licence: NM  M-05747)
Enumeration Date2007-12-27
Last Update Date2012-05-15
Business Address
-- BRENT LANE CLOVIS LMSW
2960 RODEO PARK DR W
SANTA FE, NM 87505-6351
Phone number: 505-469-6000
Mailing Address
-- BRENT LANE CLOVIS LMSW
2960 RODEO PARK DR W
SANTA FE, NM 87505-6351
Phone number: 505-469-6000