Individual
ALFREDO S ARAGON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
2211 LOMAS BLVD NE, ALBUQUERQUE, NM 87106-2745
(505) 272-4763
(505) 272-0690
Mailing address
933 BRADBURY DR SE, SUITE 2222, ALBUQUERQUE, NM 87106-4374
(505) 272-3120
(505) 272-8060
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
0967
NM
103TC0700X
Clinical Psychologist
Primary
0967
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NM302552
MEDICARE PTAN
NM
Enumeration date
07/20/2009
Last updated
06/05/2012
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