Individual
MR. KEVIN JAMES OBRIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
2504 CAMIO ENTRADA, SANTA FE, NM 87507-5456
(505) 471-5006
Mailing address
2504 CAMINO ENTRADA, SANTA FE FAMILY WELLNESS CENTER, SANTA FE, NM 87507
(505) 471-5006
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I-07396
NM
Other
Enumeration date
08/15/2011
Last updated
08/09/2019
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