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General NPI Number Information
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NPI Number | 1104375344
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Entity Type | Organization
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Legal Business Name | KRISTY L. SCULLION-MCPHERSON, PHD
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Dates
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Enumeration Date | 09/29/2016
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Last Update Date | 09/29/2016
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Provider Practice Location Address
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Address Line | 350 EL MOLINO BLVD
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City | LAS CRUCES
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State | NM
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Zip | 88005-2915
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Country | US
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Telephone | 575-642-7200
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Fax | 575-524-5968
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Provider Business Mailing Address
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Address Line | 350 EL MOLINO BLVD
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City | LAS CRUCES
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State | NM
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Zip | 88005-2915
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Country | US
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Telephone | 575-642-7200
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Fax | 575-524-5968
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Authorized Official
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Title or Position | OWNER
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Name | KRISTY L. SCULLION-MCPHERSON
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Credential | PHD
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Telephone | 575-642-7200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 1013
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License Number State | NM
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