Individual
MR. TIMOTHY HUGH SCANNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
500 UNSER BLVD SE STE 103, RIO RANCHO, NM 87124-4660
(505) 404-0554
Mailing address
9805 SAN GABRIEL RD NE, ALBUQUERQUE, NM 87111-3530
(505) 280-5753
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
X-11654
NM
Other
Enumeration date
09/09/2020
Last updated
09/09/2020
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