Individual
MARK WILLIAM RAYBOULD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LISW
Contact information
Practice address
2811 INDIAN SCHOOL RD NE, ALBUQUERQUE, NM 87106-1825
(505) 573-4044
(505) 573-4044
Mailing address
PO BOX 30811, ALBUQUERQUE, NM 87190-0811
(505) 573-4044
(505) 573-4044
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I-04965
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
51681374
—
NM
Enumeration date
03/01/2006
Last updated
06/03/2008
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