Raybould, Mark William
Raybould, Mark William is an sole proprietor health care provider with primary practice located at 2811 Indian School Rd Ne , Albuquerque NM 87106-1825. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Raybould, Mark William can be contacted via phone (505) 573-4044.Contact Information
Primary practice address
2811 Indian School Rd Ne
Albuquerque NM 87106-1825
Phone: (505) 573-4044
Fax: (505) 573-4044
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | I-04965 | New Mexico |
Profile Details
| NPI number | 1124095096 |
|---|---|
| LBN Legal business name | Raybould, Mark William |
| Credentials | LISW |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 1st, 2006 |
| Last updated | Jun 3rd, 2008 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1124095096 | NPPES |
| New Mexico | MEDICAID | 51681374 |
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