Individual
GEORGE STEVEN MADRID
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
630 HAINES AVE NW, ALBUQUERQUE, NM 87102-1226
(505) 268-5611
Mailing address
630 HAINES AVE NW, ALBUQUERQUE, NM 87102-1226
(505) 268-5611
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CSA0207901
NM
101YA0400X
Addiction (Substance Use Disorder) Counselor
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Other
Enumeration date
08/13/2020
Last updated
08/13/2020
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