Healthcare Provider Details

I. General information

NPI: 1700496601
Provider Name (Legal Business Name): ACCESS NEUROPSYCHOLOGY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2020
Last Update Date: 08/05/2020
Certification Date: 08/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 CONSTITUTION AVE NE STE C
ALBUQUERQUE NM
87106-1243
US

IV. Provider business mailing address

3400 CONSTITUTION AVE NE STE C
ALBUQUERQUE NM
87106-1243
US

V. Phone/Fax

Practice location:
  • Phone: 505-270-4242
  • Fax:
Mailing address:
  • Phone: 505-270-4242
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: ANDREA RAE SHERWOOD
Title or Position: OWNER
Credential: PHD
Phone: 505-220-7436