| Peter Smith Psyd Llc | |
|
101 Livingston Loop Ste 1 Santa Teresa NM 88008-9753 | |
| (505) 506-2546 | |
| (575) 201-7070 |
| Full Name | Peter Smith Psyd Llc |
|---|---|
| Speciality | Psychologist - Prescribing (medical) |
| Location | 101 Livingston Loop Ste 1, Santa Teresa, New Mexico |
| Authorized Official Name and Position | Claudia Naranjo (AUTHORIZED AGENT) |
| Authorized Official Contact | 9152569028 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Peter Smith Psyd Llc 60 Beach St South Portland ME 04106-1607 Ph: (520) 271-9673 | Peter Smith Psyd Llc 101 Livingston Loop Ste 1 Santa Teresa NM 88008-9753 Ph: (505) 506-2546 |
| NPI Number | 1073210316 |
|---|---|
| Provider Enumeration Date | 02/07/2023 |
| Last Update Date | 03/23/2023 |
| Certification Date | 03/23/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073210316 | NPI | - | NPPES |
| 22639560 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TP0016X | Psychologist - Prescribing (medical) | (* (Not Available)) | Primary |
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