Organization · Type 2 NPI

Primary Wellness Team Corporation

Prescribing (Medical) Psychologist · Santa Teresa, NM

NPI number 1417489378 Active

Practice location

5805 Mcnutt Rd, Ste D
Santa Teresa, NM 88008-8001

Mailing address

205 W Boutz Rd, Bldg 1
Las Cruces, NM 88005-3262

Specialties and licenses

TaxonomyCodeLicense
Prescribing (Medical) Psychologist Primary 103TP0016XNone listed

Prescribing (Medical) Psychologist: A licensed, doctoral-level psychologist authorized to prescribe and has undergone specialized education and training in preparation for prescriptive practice and has passed an examination accepted by the state board of psychology relevant to establishing competence for prescribing, and has received from the state board of psychology a current certificate granting prescriptive authority, which has not been revoked or…

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About NPI 1417489378

Primary Wellness Team Corporation's National Provider Identifier is 1417489378, issued on Mar 30, 2017. The primary taxonomy on file is Prescribing (Medical) Psychologist (103TP0016X), and the practice location is in Santa Teresa, NM. The record was last updated on Jun 30, 2017.