Provider Demographics
NPI:1548438070
Name:ROWLAND, JANE LAURIE (LISW)
Entity type:Individual
Prefix:MRS
First Name:JANE
Middle Name:LAURIE
Last Name:ROWLAND
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 MISSION ARCH DR
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:NM
Mailing Address - Zip Code:88201-6786
Mailing Address - Country:US
Mailing Address - Phone:575-578-0393
Mailing Address - Fax:
Practice Address - Street 1:500 N MAIN ST
Practice Address - Street 2:400 J
Practice Address - City:ROSWELL
Practice Address - State:NM
Practice Address - Zip Code:88201-4729
Practice Address - Country:US
Practice Address - Phone:575-910-4425
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-19
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMI-066781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical