Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | 247549 | NM |
NPI | 1063549210 |
---|---|
Provider Name | Ms. Martha A Ward |
First Address | Las Cruces, NM 88001-1206 |
Second Address | Las Cruces, NM 88001-1206 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2007 |
Last Update Date | 08/07/2007 |