Individual
MR. EVER IVAN CORRAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SCHOOL PSYCHOLOGIST
Contact information
Practice address
505 S MAIN ST STE 249, LAS CRUCES, NM 88001-1243
(575) 527-5884
(575) 527-5886
Mailing address
1961 REDWOOD ST, LAS CRUCES, NM 88001-2419
(575) 680-5645
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
370711
NM
Other
Enumeration date
08/17/2016
Last updated
08/17/2016
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