Individual
TIMOTHY G. ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LADAC
Contact information
Practice address
5901 ZUNI RD SE, ALBUQUERQUE, NM 87108-3073
(505) 841-8978
(505) 383-1196
Mailing address
5901 ZUNI RD SE, ALBUQUERQUE, NM 87108-3073
(505) 841-8978
(505) 383-1196
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0143421
NM
Other
Enumeration date
02/26/2013
Last updated
02/26/2013
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