Individual
ALFREDO BOLANOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSW
Contact information
Practice address
2551 COORS BLVD NW, ALBUQUERQUE, NM 87120-1213
(505) 338-3320
Mailing address
2551 COORS BLVD NW, ALBUQUERQUE, NM 87120-1213
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
L7094
—
NM
Enumeration date
09/09/2009
Last updated
06/24/2015
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