Individual
MR. THOMAS R CORDOVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
3505 CHELWOOD PARK NE, ALBUQUERQUE, NM 87111
(505) 270-8706
Mailing address
3505 CHELWOOD PARK NE, ALBUQUERQUE, NM 87111
(505) 270-8706
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0160571
NM
373H00000X
Day Training/Habilitation Specialist
—
—
Other
Enumeration date
03/27/2013
Last updated
11/15/2013
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