Sandy Etigson

Individual provider Active NPI School Psychologist · Mescalero, NM

NPI 1841404605 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1841404605
Entity type
Individual (NPI type 1)
Primary specialty
School Psychologist 103TS0200X
License
2458 (NM)
Practice address
249 White Mountain Dr
Mescalero, NM 88340-9622
Phone
(505) 464-4431
Fax
(505) 464-4822
NPI assigned
May 10, 2007
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2458NMMDOccupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist 103TS0200X 2458 NM Yes

Addresses

Primary practice location

249 White Mountain Dr
Mescalero, NM 88340-9622

Mailing address

249 White Mountain Dr
Mescalero, NM 88340-9622
Phone (505) 464-4431

Other providers in Mescalero, NM

All providers in Mescalero, NM · School Psychologist in New Mexico

Sources for this page

Verify at the official NPI Registry.