Individual
DONNA M. KWILOSZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
7007 WYOMING BLVD NE, SUITE A2, ALBUQUERQUE, NM 87109-3987
(505) 765-2370
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-6770
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0994
NM
Other
Enumeration date
05/15/2007
Last updated
12/29/2017
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