Individual
OWEN CHEYKAYCHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LADAC
Contact information
Practice address
112 MONROE ST NE, ALBUQUERQUE, NM 87108-1247
(505) 260-9917
Mailing address
112 MONROE ST NE, ALBUQUERQUE, NM 87108-1247
(505) 260-9917
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CAD0201441
NM
Other
Enumeration date
01/04/2019
Last updated
02/05/2021
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