Individual
MR. ALI SCOTT MOGHADAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8205 SPAIN RD NE STE 106, ALBUQUERQUE, NM 87109-3155
(505) 856-0300
(505) 856-7946
Mailing address
2519 FLOR SILVESTRE NW, ALBUQUERQUE, NM 87120-1354
(505) 584-6652
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CTB-2023-1041
NM
Other
Enumeration date
06/24/2024
Last updated
07/03/2024
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