Healthcare Provider Details

I. General information

NPI: 1417394628
Provider Name (Legal Business Name): EVE M ADAMS PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/29/2013
Last Update Date: 05/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1220 STEWART ST O'DONNELL HALL, RM 205
LAS CRUCES NM
88003
US

IV. Provider business mailing address

MSC 3CEP, BOX 30001 COUNSELING AND EDUCATIONAL PSYCHOLOGY DEPT. NMSU
LAS CRUCES NM
88003-8001
US

V. Phone/Fax

Practice location:
  • Phone: 575-646-1142
  • Fax: 575-646-8035
Mailing address:
  • Phone: 575-646-1142
  • Fax: 575-646-8035

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number0836
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: