Kevin Ryan Puckett I, LSAA

NPI #1881207496 in Albuquerque, New Mexico

Provider Information

NPI Number: 1881207496
Entity Type: Individual
Name: Kevin Ryan Puckett I, LSAA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Psychologist - Addiction (Substance Use Disorder)
Credential: LSAA
Enumeration Date: Aug 25, 2020
Last Updated: Aug 25, 2020

Practice Location

Address: 1528 FIVE POINTS RD SW
City: Albuquerque
State: New Mexico
ZIP Code: 87105-3179
Phone: (505) 242-6919

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder)	103TA0400X	Primary

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