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General NPI Number Information
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NPI Number | 1700496601
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Entity Type | Organization
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Legal Business Name | ACCESS NEUROPSYCHOLOGY, LLC
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Dates
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Enumeration Date | 08/05/2020
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Last Update Date | 08/05/2020
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Provider Practice Location Address
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Address Line | 3400 CONSTITUTION AVE NE STE C
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City | ALBUQUERQUE
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State | NM
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Zip | 87106-1243
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Country | US
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Telephone | 505-270-4242
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Fax |
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Provider Business Mailing Address
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Address Line | 3400 CONSTITUTION AVE NE STE C
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City | ALBUQUERQUE
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State | NM
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Zip | 87106-1243
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Country | US
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Telephone | 505-270-4242
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ANDREA RAE SHERWOOD
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Credential | PHD
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Telephone | 505-220-7436
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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 |
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License Number State |
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