Individual
TIM HOGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5301 PONDEROSA AVE NE, ALBUQUERQUE, NM 87110-1216
(505) 881-8982
Mailing address
1764 LEE LOOP NE, RIO RANCHO, NM 87144-5472
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/03/2010
Last updated
08/03/2010
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