Individual
MARY ELIZABETH KLOTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
2811 INDIAN SCHOOL RD NE, ALBUQUERQUE, NM 87106-1825
(505) 449-7209
Mailing address
2811 INDIAN SCHOOL RD NE, ALBUQUERQUE, NM 87106-1825
(505) 449-7209
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1222
NM
103T00000X
Psychologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65078721
—
NM
Enumeration date
09/30/2009
Last updated
01/22/2021
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