Individual
KARL RICHARD PONCHALEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LISW
Contact information
Practice address
1 UNIV OF NM, MSC06 UMN STUDENT HEALTH CENTER, ALBUQUERQUE, NM 87131-0001
(505) 277-3136
(505) 277-5668
Mailing address
1 UNIV OF NM, MSC06 UMN STUDENT HEALTH CENTER, ALBUQUERQUE, NM 87131-0001
(505) 277-3136
(505) 277-5668
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
I05319
NM
Other
Enumeration date
02/28/2007
Last updated
07/08/2007
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