Individual
ASA JOE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2051 WYOMING BLVD NE, ALBUQUERQUE, NM 87112-2615
(505) 226-4359
Mailing address
2051 WYOMING BLVD NE, ALBUQUERQUE, NM 87112-2615
(505) 226-4359
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
12/09/2025
Last updated
04/10/2026
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