Provider Demographics
NPI:1760921761
Name:MORAN-OLIVAS, HILDA LIZETH (LMSW)
Entity Type:Individual
Prefix:
First Name:HILDA
Middle Name:LIZETH
Last Name:MORAN-OLIVAS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 W LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:DEMING
Mailing Address - State:NM
Mailing Address - Zip Code:88030-5031
Mailing Address - Country:US
Mailing Address - Phone:575-494-6012
Mailing Address - Fax:
Practice Address - Street 1:901 W HICKORY ST
Practice Address - Street 2:
Practice Address - City:DEMING
Practice Address - State:NM
Practice Address - Zip Code:88030-4046
Practice Address - Country:US
Practice Address - Phone:575-546-2174
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-23
Last Update Date:2017-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMX-09895104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker