Organization
TIERRA ALTA NEUROPSYCHOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER MONZONES (OWNER AND CLINICAL NEUROPSYCHOLOGIS)
(917) 805-7945
Entity
Organization
Contact information
Practice address
1911 5TH ST STE 206, SANTA FE, NM 87505-5403
(505) 695-5675
Mailing address
1911 5TH ST STE 206, SANTA FE, NM 87505-5403
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
04/07/2023
Last updated
06/12/2024
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