Doctor Name: | ALFREDO GOVEA |
NPI Number: | 1104228998 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 361615 |
Business Practice Address: | 2810 N Swan St Silver City, NM - 880615853 |
Business Phone Number: | 5759562043 |
Business Fax Number: | |
Mailing Address: | 919 W Ash St, DEMING |
State: | NM |
Postal Code: | 880304024 |
Phone Number: | 9159208466 |
Fax Number: | |
NPI Enumeration Date: | 09/23/2014 |
NPI Last Update Date: | 09/23/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TS0200X |
License Number: | 361615 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NM |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | School |
Taxonomy Definition: |