Organization Name: | PSYCHOLOGICAL ASSESSMENT & TREATMENT CENTER, LLC |
NPI Number: | 1821370842 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LAURA LOUISE SMITH (MANAGING MEMBER) |
Mailing Address: | 4313 Corrales Rd Corrales |
State: | NM US |
Postal Code: | 870488663 |
Phone Number: | 5054403595 |
Fax Number: | 8556906884 |
NPI Enumeration Date: | 09/15/2011 |
NPI Last Update Date: | 09/15/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103G00000X |
License Number: | 757 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NM |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Clinical Neuropsychologist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |