| Ricardo Gonzales, Ph.d., Psychological Services, Llc | |
|
168 Ave. Ponderosa Glorieta NM 87535 | |
| (505) 757-2216 | |
| Not Available |
| Full Name | Ricardo Gonzales, Ph.d., Psychological Services, Llc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 168 Ave. Ponderosa, Glorieta, New Mexico |
| Authorized Official Name and Position | Ricardo R. Gonzales (CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 5057572216 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ricardo Gonzales, Ph.d., Psychological Services, Llc Po Box 325 Glorieta NM 87535-0325 Ph: (505) 757-2216 | Ricardo Gonzales, Ph.d., Psychological Services, Llc 168 Ave. Ponderosa Glorieta NM 87535 Ph: (505) 757-2216 |
| NPI Number | 1639444920 |
|---|---|
| Provider Enumeration Date | 03/20/2012 |
| Last Update Date | 04/02/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639444920 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | #414 (New Mexico) | Primary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | #414 (New Mexico) | Secondary |