Individual
MR. COLMAN CARROLL MCCANNA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3876 HAWKINS ST NE, ALBUQUERQUE, NM 87109-4539
(505) 508-0865
Mailing address
6200 MONTANO PLAZA DR NW APT 2427, ALBUQUERQUE, NM 87120-5786
(260) 437-6962
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/22/2020
Last updated
07/22/2020
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