Individual
JEREMY L NAGORSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8600 ACADEMY RD NE, ALBUQUERQUE, NM 87111-1107
(505) 821-3628
Mailing address
8600 ACADEMY RD NE, ALBUQUERQUE, NM 87111-1107
(505) 821-3628
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CTB-2022-0828
NM
Other
Enumeration date
10/24/2022
Last updated
10/27/2022
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