Individual
MR. TIMOTHY W. BASHA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LADAC
Contact information
Practice address
1613 JUNIPER DR., ALAMOGORDO, NM 88310
(575) 495-8098
(866) 521-8354
Mailing address
PO BOX 1088, ALAMOGORDO, NM 88311-1088
(575) 495-8098
(866) 521-8354
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0147651
NM
Other
Enumeration date
04/17/2015
Last updated
09/09/2021
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