Individual
SAMUEL ROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
201 TULANE DR SE, ALBUQUERQUE, NM 87106-1413
(505) 255-9494
(505) 242-4763
Mailing address
1616 SAN PATRICIO AVE SW, ALBUQUERQUE, NM 87104-1048
(505) 255-9494
(505) 242-4763
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
105
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
105
NM LICENSE NO
NM
Enumeration date
08/31/2006
Last updated
05/12/2008
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