Individual
LEE A. ACOSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2551 COORS BLVD NW, ALBUQUERQUE, NM 87120-1213
(505) 366-2400
Mailing address
2551 COORS BLVD NW, ALBUQUERQUE, NM 87120-1213
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
103K00000X
Behavior Analyst
—
—
Other
Enumeration date
06/11/2012
Last updated
09/26/2012
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