Individual
DR. ARDYTH A. NOREM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.S.
Contact information
Practice address
15 E CHILI LINE RD, SANTA FE, NM 87508-1395
(505) 473-4017
Mailing address
15 E CHILI LINE RD, SANTA FE, NM 87508-1395
(505) 473-4017
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
0817
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00JM96
BCBS
NM
05
—
36573353
—
NM
01
—
89991
PRESBYTERIAN
NM
01
—
P00073759
RAILROAD MEDICARE
NM
Enumeration date
08/06/2006
Last updated
07/09/2007
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