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Individual

EUGENE WELLS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LISW

Contact information

Practice address
3824 CORRALES RD, CORRALES, NM 87048-9306
(505) 804-5457
Mailing address
505 2ND ST SW, #1, ALBUQUERQUE, NM 87102-3970

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I06224
NM

Other

Enumeration date
10/16/2009
Last updated
10/16/2009
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