Individual
DR. LANA R. LANDRUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
243 LOS ALAMOS HWY, ESPANOLA, NM 87532-2731
(505) 753-0773
(505) 753-0775
Mailing address
243 LOS ALAMOS HWY, ESPANOLA, NM 87532-2731
(505) 753-0773
(505) 753-0775
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
758
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
63939
PRESBYTERIAN HEALTH PLAN
NM
05
—
NM100034
—
NM
Enumeration date
11/17/2006
Last updated
07/08/2007
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