Individual
DR. HOMER AVALOS AVALOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
336 GERONIMO, CHAPPARAL, NM 88081
(915) 691-5555
Mailing address
300-2 MCCOMBS RD # 16, CHAPARRAL, NM 88081-7937
(915) 691-5555
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1780
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NM10061
—
NM
Enumeration date
05/04/2007
Last updated
07/08/2007
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