Individual
MR. PHILLIP ADAM MORA JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPSW
Contact information
Practice address
933 BRADBURY DR SE STE 2222, ALBUQUERQUE, NM 87106-4375
(505) 544-6265
Mailing address
933 BRADBURY DR SE STE 2222, ALBUQUERQUE, NM 87106-4375
(505) 544-6265
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
175T00000X
Peer Specialist
Primary
1077
NM
175T00000X
Peer Specialist
—
—
Other
Enumeration date
11/05/2020
Last updated
11/09/2020
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