KEVIN RYAN PUCKETT

ALBUQUERQUE, NM
NPI1881207496
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy103TA0400X Psychologist Addiction (Substance Use Disorder)
(Licence: NM  CSA0210841)
Enumeration Date2020-08-25
Last Update Date2020-08-25
Business Address
KEVIN RYAN PUCKETT LSAA
1528 FIVE POINTS RD SW
ALBUQUERQUE, NM 87105-3179
Phone number: 505-242-6919
Mailing Address
KEVIN RYAN PUCKETT LSAA
1805 LLANO CT NW
ALBUQUERQUE, NM 87107-2631
Phone number: 505-506-7595
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