Individual
TOM JAMES KOSBAB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
301 LOMA COLORADO ST NE, RIO RANCHO, NM 87124-6562
(505) 896-5897
Mailing address
4430 AVENIDA MANANA NE, ALBUQUERQUE, NM 87110-6169
(505) 265-2077
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
M-04780
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
53174216
—
NM
Enumeration date
01/25/2007
Last updated
07/08/2007
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