Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 1236 | CO |
Y | 103TC0700X | Clinical Psychologist | 1236 | CO |
NPI | 1013055862 |
---|---|
Provider Name | Dr. Gary J Neuger |
First Address | Albuquerque, NM 87199-4508 |
Second Address | Albuquerque, NM 87109 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2007 |
Last Update Date | 31/05/2018 |