Robert Ericson, Phd | |
6463 4th St Nw Suite C Los Ranchos De Albuquerque NM 87107-5810 | |
(505) 344-9500 | |
(505) 342-1084 |
Full Name | Robert Ericson, Phd |
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Speciality | Psychologist - Cognitive & Behavioral |
Location | 6463 4th St Nw, Los Ranchos De Albuquerque, New Mexico |
Authorized Official Name and Position | Robert Charles Ericson (PRESIDENT) |
Authorized Official Contact | 5052426672 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Robert Ericson, Phd 6463 4th St Nw Suite C Los Ranchos De Albuquerque NM 87107-5810 Ph: (505) 344-9500 | Robert Ericson, Phd 6463 4th St Nw Suite C Los Ranchos De Albuquerque NM 87107-5810 Ph: (505) 344-9500 |
NPI Number | 1700069796 |
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Provider Enumeration Date | 12/12/2007 |
Last Update Date | 08/05/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1700069796 | NPI | - | NPPES |
NM00N206 | Other | NM | BLUE CROSS BLUE SHIELD |
N8396 | Medicaid | NM |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TB0200X | Psychologist - Cognitive & Behavioral | 239 (New Mexico) | Primary |