Organization
BEST SELF THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KYLE MICHAEL ROUCKUS (LICSW)
(505) 363-3313
Entity
Organization
Contact information
Practice address
2201 MENAUL BLVD NE STE A, ALBUQUERQUE, NM 87107-1711
(917) 854-6331
Mailing address
2201 MENAUL BLVD NE STE A, ALBUQUERQUE, NM 87107-1711
(917) 854-6331
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
04/22/2024
Last updated
04/22/2024
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