Individual
MARK LOUIS BOSCHELLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S.
Contact information
Practice address
2600 MARBLE AVE NE, ALBUQUERQUE, NM 87106-2058
(505) 272-2800
(505) 272-8692
Mailing address
933 BRADBURY DR SE, ALBUQUERQUE, NM 87106-4374
(505) 272-3120
(505) 272-8060
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0067632
NM
101YM0800X
Mental Health Counselor
Primary
0056
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000B809
—
NM
Enumeration date
07/09/2006
Last updated
04/30/2012
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