Organization
J. MICHAEL MASH PRESCRIBING PSYCHOLOGIST LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES MASH (OWNER/PH.D.)
(575) 776-7432
Entity
Organization
Contact information
Practice address
4155 STATE ROAD 68, UNIT 6, RANCHO DE TAOS, NM 87557
(575) 776-7432
Mailing address
PO BOX 94508, ALBUQUERQUE, NM 87199-4508
(505) 384-7352
Taxonomy
Speciality
Code
Description
License number
State
103TP0016X
Prescribing (Medical) Psychologist
Primary
609
NM
Other
Enumeration date
08/28/2016
Last updated
08/28/2016
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