Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | 342047 | NM |
NPI | 1083923635 |
---|---|
Provider Name | Ana Lourdes Magallanes |
First Address | Las Cruces, NM 88001-1243 |
Second Address | Las Cruces, NM 88001-1243 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/09/2010 |
Last Update Date | 09/08/2019 |