Healthcare Provider Details

I. General information

NPI: 1205039930
Provider Name (Legal Business Name): MARY ANN COTTEN AND ASSOCIATES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2007
Last Update Date: 10/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1408 8TH ST
ALAMOGORDO NM
88310-5105
US

IV. Provider business mailing address

1408 8TH ST
ALAMOGORDO NM
88310-5105
US

V. Phone/Fax

Practice location:
  • Phone: 575-439-1550
  • Fax: 575-439-1552
Mailing address:
  • Phone: 575-439-1550
  • Fax: 575-439-1552

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number0791
License Number StateNM

VIII. Authorized Official

Name: DR. MARY ANN COTTEN
Title or Position: OWNER
Credential: PH.D.
Phone: 575-439-1550