Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 759 | NM |
Y | 103T00000X | Psychologist | 759 | NM |
N | 103G00000X | Clinical Psychologist | 759 | NM |
N | 103TC0700X | Clinical Psychologist | 759 | NM |
NPI | 1013938604 |
---|---|
Provider Name | Dr. Pamela W Linnell |
First Address | Roswell, NM 88202-1178 |
Second Address | Roswell, NM 88201-5016 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2006 |
Last Update Date | 14/05/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
76675 | (05) | NM |
P10040 | (02) | NM |