Suzette Lorraine Gordon, NM LSP
Individual provider Active NPI School Psychologist · Aztec, NM
NPI 1831346469 · NPPES record last updated Aug 26, 2008
Key facts
- NPI
- 1831346469
- Entity type
- Individual (NPI type 1)
- Primary specialty
- School Psychologist 103TS0200X
- License
- 220939 (NM)
- Practice address
- 1607 W. Aztec Blvd.
Aztec Municipal Schools
Aztec, NM 87410 - Phone
- (505) 334-1730
- NPI assigned
- Aug 26, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 220939 | NM | MD | School Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aztec Municipal Schools | Past | Accepting new patients | |
| Aztec Municipal School District | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 220939 | NM | Yes |
Addresses
Primary practice location
1607 W. Aztec Blvd.
Aztec Municipal Schools
Aztec, NM 87410
Mailing address
1607 W. Aztec Blvd.
Aztec Municipal Schools
Aztec, NM 87410
Phone (505) 334-1730
Other providers in Aztec, NM
- Cassandra Lee Gamboa
- Genevieve Garcia
- Parker Gaughan
- Aimee Aline Geiger
- Amber Gipson
- Margaret Irene Gores
- Janet Lee Gorham
- Crystal Goss
- Summer Graham
- Sara Gutierrez
All providers in Aztec, NM · School Psychologist in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 26, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.