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General NPI Number Information
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NPI Number | 1619345022
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Entity Type | Individual
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Provider Name | EVELYN PLUMB PHD
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Gender | Female
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Dates
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Enumeration Date | 09/02/2015
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Last Update Date | 10/14/2024
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Provider Practice Location Address
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Address Line | 6121 INDIAN SCHOOL RD NE STE 143
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City | ALBUQUERQUE
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State | NM
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Zip | 87110-3176
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Country | US
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Telephone | 505-542-4970
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Fax | 505-213-6301
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Provider Business Mailing Address
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Address Line | PO BOX 1085
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City | TAOS
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State | NM
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Zip | 87571-1085
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Country | US
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Telephone | 707-367-4039
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Fax |
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY1620
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License Number State | NM
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