Most Relevant Information
Provider Data
| NPI Number: | 1003649575 |
| Provider Name: | DERRIN MACKENZIE BELL PSS |
| Entity Type: | Individual |
| Taxonomy Code: | 175T00000X |
| Specialty: | Peer Specialist |
| License Number: | 1744 |
Most Important Dates
| Enumeration Date: | 08/21/2024 |
| Last Updated: | 08/21/2024 |
Provider Practice Location
11401 MENAUL BLVD NE
ALBUQUERQUE
NM
871122435
Practice Location Phone/Fax
| Phone: | 5055263649 |
| Fax: |
Provider Mailing Location
2913 PALO VERDE DR NE APT A
ALBUQUERQUE
NM
871122175
Provider Mailing Phone/Fax
| Phone: | 5053216968 |
| Fax: |