Individual
MR. MICHAEL SHAWN MCCOLLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
1501 SAN PEDRO DR SE DEPT VA, ALBUQUERQUE, NM 87108-5153
(505) 503-3012
Mailing address
1501 SAN PEDRO DR SE DEPT VA, ALBUQUERQUE, NM 87108-5153
(505) 503-3012
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
41557
TX
1041C0700X
Clinical Social Worker
Primary
41557
TX
Other
Enumeration date
05/11/2006
Last updated
12/04/2014
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