Individual
DR. MICHAEL DEBERNARDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
2325 CERRILLOS RD, SANTA FE, NM 87505-3373
(505) 438-0010
(505) 438-6011
Mailing address
640 HERMIT FALLS DR SE, RIO RANCHO, NM 87124-7285
(505) 670-3868
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
742
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Z7066
—
NM
Enumeration date
01/09/2007
Last updated
07/08/2007
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