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General NPI Number Information
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NPI Number | 1003982174
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Entity Type | Individual
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Provider Name | JOSEPH ALFRED BOUSQUET MSW, PHD
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Gender | Male
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Dates
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Enumeration Date | 11/28/2006
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Last Update Date | 09/05/2014
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Provider Practice Location Address
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Address Line | ONE SAN RAFAEL THE COGNITIVE BEHAVORIAL INSTITUTE OF ALBUQUERQUE
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City | ALBUQUERQUE
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State | NM
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Zip | 87122
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Country | US
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Telephone | 505-832-1600
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Fax | 505-832-1161
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Provider Business Mailing Address
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Address Line | ONE SAN RAFAEL THE COGNITIVE BEHAVORIAL INSTITUTE OF ALBUQUERQUE
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City | ALBUQUERQUE
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State | NM
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Zip | 87122
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Country | US
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Telephone | 505-832-1600
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Fax | 505-832-1161
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 864
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 1174
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License Number State | NM
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