Individual
MICHAEL EUGENE SMALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3150 CARLISLE BLVD NE, ALBUQUERQUE, NM 87110-1678
(505) 638-8178
Mailing address
3150 CARLISLE BLVD NE, ALBUQUERQUE, NM 87110-1678
(505) 638-8178
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CTB-2022-0902
NM
Other
Enumeration date
06/07/2022
Last updated
12/18/2024
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