Provider Demographics
NPI:1821412115
Name:GIGGER, MARTHA (MA, LBSW)
Entity Type:Individual
Prefix:MRS
First Name:MARTHA
Middle Name:
Last Name:GIGGER
Suffix:
Gender:F
Credentials:MA, LBSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:602 E 34TH ST
Mailing Address - Street 2:
Mailing Address - City:SILVER CITY
Mailing Address - State:NM
Mailing Address - Zip Code:88061-7249
Mailing Address - Country:US
Mailing Address - Phone:575-313-2173
Mailing Address - Fax:
Practice Address - Street 1:2810 N SWAN ST
Practice Address - Street 2:
Practice Address - City:SILVER CITY
Practice Address - State:NM
Practice Address - Zip Code:88061-5853
Practice Address - Country:US
Practice Address - Phone:575-956-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-07
Last Update Date:2014-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMB-051311041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool