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1710205596
MICJHAEL PATRICK O'MALLEY
LAS CRUCES, NM
NPI
1710205596
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: NM LADAC3619)
Enumeration Date
2010-05-04
Last Update Date
2010-05-04
Business Address
Mr. MICJHAEL PATRICK O'MALLEY LADAC
715 E IDAHO AVE 4B
LAS CRUCES, NM 88001-4703
Phone number: 575-524-2505
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Mailing Address
Mr. MICJHAEL PATRICK O'MALLEY LADAC
PO BOX 373
RADIUM SPRINGS, NM 88054-0373
Phone number: 575-621-9660
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