| Child Psychology Center | |
|
3751 N Butler Ave Ste 115 Farmington NM 87401-6425 | |
| (662) 603-1035 | |
| Not Available |
| Full Name | Child Psychology Center |
|---|---|
| Speciality | Psychologist - Clinical Child & Adolescent |
| Location | 3751 N Butler Ave Ste 115, Farmington, New Mexico |
| Authorized Official Name and Position | Priscilla Roth-wall (PSYCHOLOGIST/OWNER) |
| Authorized Official Contact | 6626031035 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Child Psychology Center 3751 N Butler Ave Ste 115 Farmington NM 87401-6425 Ph: (662) 603-1035 | Child Psychology Center 3751 N Butler Ave Ste 115 Farmington NM 87401-6425 Ph: (662) 603-1035 |
| NPI Number | 1528603743 |
|---|---|
| Provider Enumeration Date | 11/12/2019 |
| Last Update Date | 11/12/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528603743 | NPI | - | NPPES |
| 16970748 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC2200X | Psychologist - Clinical Child & Adolescent | (* (Not Available)) | Primary |
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