Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TB0200X | Cognitive & Behavioral Psychologist | 0764 | NM |
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | 0764 | NM |
N | 103TF0000X | Family Psychologist | 0764 | NM |
N | 103TS0200X | School Psychologist | NM |
NPI | 1063677003 |
---|---|
Provider Name | Dr. Marcela Cecilia Acevedo |
First Address | Albuquerque, NM 87106-0000 |
Second Address | Albuquerque, NM 87106-3224 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2008 |
Last Update Date | 19/04/2010 |