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General NPI Number Information
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NPI Number | 1871076539
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Entity Type | Individual
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Provider Name | PATRICK SCOTT LCSW
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Gender | Male
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Dates
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Enumeration Date | 09/10/2018
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Last Update Date | 09/10/2018
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Provider Practice Location Address
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Address Line | 7801 WILSHIRE AVE NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87122-2807
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Country | US
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Telephone | 505-823-2327
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 25704
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City | ALBUQUERQUE
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State | NM
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Zip | 87125-0704
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Country | US
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Telephone |
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Fax |
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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 | 1041S0200X
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Taxonomy Name | School Social Worker
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License Number | C-08522
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License Number State | NM
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