| Region Ix Education Cooperative | |
|
1400 Sudderth Dr Ruidoso NM 88345-6103 | |
| (505) 257-2368 | |
| (505) 257-2141 |
| Full Name | Region Ix Education Cooperative |
|---|---|
| Speciality | Psychologist - School |
| Location | 1400 Sudderth Dr, Ruidoso, New Mexico |
| Authorized Official Name and Position | Evelyn Sanchez (MEDICAID SERVICES TECHNICIAN) |
| Authorized Official Contact | 5052572368 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Region Ix Education Cooperative 1400 Sudderth Dr Ruidoso NM 88345-6103 Ph: (505) 257-2368 | Region Ix Education Cooperative 1400 Sudderth Dr Ruidoso NM 88345-6103 Ph: (505) 257-2368 |
| NPI Number | 1245312719 |
|---|---|
| Provider Enumeration Date | 10/20/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245312719 | NPI | - | NPPES |
| Q5515 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TS0200X | Psychologist - School | 257884 (New Mexico) | Primary |
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