Provider Demographics
NPI:1346400660
Name:BOSWELL, CAL BARKLEY
Entity type:Individual
Prefix:
First Name:CAL
Middle Name:BARKLEY
Last Name:BOSWELL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3509 SMITH AVE SE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-1605
Mailing Address - Country:US
Mailing Address - Phone:505-262-0444
Mailing Address - Fax:
Practice Address - Street 1:3509 SMITH AVE SE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-1605
Practice Address - Country:US
Practice Address - Phone:505-262-0444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-10
Last Update Date:2010-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor