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Individual

ANDRE MCCABE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
118 S MAIN STREET, LAS CRUCES, NM 88001
(575) 680-0787
Mailing address
2207 GARRISON RD, LAS CRUCES, NM 88001-5750
(575) 680-0787

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
X06219
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
47043
NM
01
850204142
MEDICARE
NM
Enumeration date
08/19/2008
Last updated
08/19/2008
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