Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 0844 | NM |
Y | 103T00000X | Psychologist | 0844 | NM |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 0844 | NM |
N | 103TC1900X | Counseling Psychologist | 0844 | NM |
N | 103TF0000X | Family Psychologist | 0844 | NM |
N | 103TP2701X | Group Psychotherapist | 0844 | NM |
NPI | 1003341975 |
---|---|
Provider Name | Dr. Corey J Vas |
First Address | Las Cruces, NM 88005-2172 |
Second Address | Las Cruces, NM 88005-2172 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2017 |
Last Update Date | 27/04/2017 |