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General NPI Number Information
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NPI Number | 1194735100
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Entity Type | Individual
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Provider Name | MICHAEL ALAN CUMMINGS PH.D.
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Gender | Male
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Dates
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Enumeration Date | 08/09/2006
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Last Update Date | 11/03/2011
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Provider Practice Location Address
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Address Line | 338 RANDALL LN
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City | TAOS
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State | NM
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Zip | 87571-5211
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Country | US
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Telephone | 575-758-0345
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Fax | 575-758-0346
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Provider Business Mailing Address
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Address Line | 338 RANDALL LN
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City | TAOS
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State | NM
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Zip | 87571-5211
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Country | US
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Telephone | 575-758-0345
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Fax | 575-758-0346
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 737
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 737
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License Number State | NM
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Taxonomy #3
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 737
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License Number State | NM
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