Grano De Oro Family Mental Health Services

NPI 1023334083 - Psychologist - 103TC0700X

NPI Details
NPI 1023334083
Enumeration Date 04/15/2010
Last Updated 04/15/2010
Entity Type Healthcare Provider
Active Over 6 years ago
Authorized Information
Name RODOLFO FIDENCIO RODOLFO
Position CLINICAL PSYCHOLOGIST
Phone (505) 617-6313
Fax
Practice Location
1920 7TH ST
LAS VEGAS NM, 87701-4956, US
Phone (505) 617-6313
Fax
Business Location
PO BOX 1856
LAS VEGAS NM, 87701-1856, US
Phone (505) 617-6313
Fax
Toxanomy
Taxonomy Code 103TC0700X
License State New Mexico
License Number 0811
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According to our database, Grano De Oro Family Mental Health Services NPI is 1023334083, taxonomy code is 103TC0700X and license number is 0811, license state is located at New Mexico. Grano De Oro Family Mental Health Services physically located at 1920 7th St, Las Vegas NM, 87701-4956. NPI Number 1033115704 has the healthcare provider type.

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1023334083 NPI number is provided on an as is basis without warranty of any kind. 1023334083 is maintained by the National Plan & Provider Enumeration System. The contents of Grano De Oro Family Mental Health Services are for informational purposes only.