Individual
ABDOLHOSSEIN ENTEZARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
5150 JOURNAL CENTER NE, ALBUQUERQUE, NM 87109
(505) 262-3212
(505) 262-3381
Mailing address
PO BOX 27829, ALBUQUERQUE, NM 87125
(505) 262-7026
(505) 727-9276
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
468
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
N0484
—
NM
Enumeration date
10/18/2006
Last updated
07/08/2007
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