Individual
MR. MICHAEL ALAN CUMMINGS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
338 RANDALL LN, TAOS, NM 87571-5211
(575) 758-0345
(575) 758-0346
Mailing address
338 RANDALL LN, TAOS, NM 87571-5211
(575) 758-0345
(575) 758-0346
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
737
NM
103TC0700X
Clinical Psychologist
Primary
737
NM
103TS0200X
School Psychologist
737
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00000Z2629
—
NM
01
—
00R624
BLUE CROSS BLUE SHIELD
NM
01
—
1194735100
MEDICARE
NM
01
—
NM100709
VALUE OPTIONS NM
NM
Enumeration date
08/09/2006
Last updated
11/03/2011
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