Organization
MILTON C. LASOSKI, PH.D, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MILTON C. LASOSKI PH.D. (REGISTERED AGENT)
(505) 266-3070
Entity
Organization
Contact information
Practice address
4253 MONTGOMERY BLVD NE, SUITE 220, ALBUQUERQUE, NM 87109-1106
(505) 342-0400
Mailing address
4253 MONTGOMERY BLVD NE, STE 220, ALBUQUERQUE, NM 87109-1106
(505) 266-3070
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
364
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
311220
PTAN
NM
Enumeration date
10/24/2014
Last updated
05/17/2016
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