Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 0802 | NM |
Y | 103TC0700X | Clinical Psychologist | 0802 | NM |
NPI | 1003927906 |
---|---|
Provider Name | Daniel Mccombs |
First Address | Las Vegas, NM 87701-9549 |
Second Address | Las Vegas, NM 87701-9549 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 08/07/2007 |