Individual
AMY SUSAN DEBERNARDI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
22 ST. ANTHONY DRIVE, ZUNI, NM 87327
(505) 782-5870
Mailing address
640 HERMIT FALLS DR SE, RIO RANCHO, NM 87124-7285
(505) 670-2313
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
755
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000N4239
—
NM
Enumeration date
02/18/2009
Last updated
02/18/2009
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