Gregory Bundrick, LISW

NPI #1871758755 in Esapnola, New Mexico

Provider Information

NPI Number: 1871758755
Entity Type: Individual
Name: Gregory Bundrick, LISW
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Social Worker
Credential: LISW
Enumeration Date: Jul 21, 2008
Last Updated: Jul 21, 2008

Practice Location

Address: 1206 NORTH RIVERSIDE DRIVE
Address 2: AYUDANTES
City: Esapnola
State: New Mexico
ZIP Code: 87532
Phone: (505) 747-0102

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker	104100000X	Primary

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