| Doctor Name: | EUGENE WELLS |
| NPI Number: | 1679808158 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LISW |
| License Number: | I06224 |
| Business Practice Address: | 3824 Corrales Rd Corrales, NM - 870489306 |
| Business Phone Number: | 5058045457 |
| Business Fax Number: | |
| Mailing Address: | 505 2nd St Sw, #1 ALBUQUERQUE |
| State: | NM |
| Postal Code: | 871023970 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 10/16/2009 |
| NPI Last Update Date: | 10/16/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | I06224 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NM |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |