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Individual

MARCIA MARIE MIDDEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
27TH SPECIAL OPERATIONS MEDICAL GROUP, 224 D. L. INGRAM AVE BLD. 1408, CANNON AFB, NM 88103
(575) 904-3951
Mailing address
675 COBBLE DR, MONTROSE, CO 81403-7813
(720) 291-9792
(888) 537-7171

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
PSY.0001757
103TC0700X
Clinical Psychologist
Primary
1757
CO

Other

Enumeration date
09/19/2005
Last updated
03/11/2024
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