Healthcare Provider Details

I. General information

NPI: 1124637541
Provider Name (Legal Business Name): BEHAVIORAL MEDICINE AND ASSESSMENT OF NEW MEXICO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2020
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1005 21ST ST SE # 6
RIO RANCHO NM
87124-4030
US

IV. Provider business mailing address

PO BOX 45121
RIO RANCHO NM
87174-5121
US

V. Phone/Fax

Practice location:
  • Phone: 505-302-1492
  • Fax:
Mailing address:
  • Phone: 505-302-1492
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. AARON KIMBALL HASLAM
Title or Position: MANAGER/PSYCHOLOGIST
Credential: PH.D.
Phone: 505-302-1492