Individual
PIYADASA KODITUWAKKU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
ADDICTION AND SUBSTANCE ABUSE PROGRAMS, 2450 ALAMO SE, ALBUQUERQUE, NM 87106
(505) 272-8833
Mailing address
2450 ALAMO AVE SE, MSC09 5030, ALBUQUERQUE, NM 87106-3204
(505) 272-8833
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
510
NM
Other
Enumeration date
07/22/2006
Last updated
01/11/2008
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