Individual
DR. CAROLE A. MAZUROWSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
6565 AMERICAS PKWY NE, SUITE 200, ALBUQUERQUE, NM 87110-8116
(505) 620-2848
(866) 578-0586
Mailing address
PO BOX 90815, ALBUQUERQUE, NM 87199-0815
(505) 620-2848
(866) 578-0586
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
0881
NM
103TB0200X
Cognitive & Behavioral Psychologist
Primary
0881
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03042935008
—
NM
01
—
NM00JL79
BLUE CROSS BLUE SHIELD NM
NM
01
—
NM202641
VALUE OPTIONS PROVIDER NO
NM
Enumeration date
11/28/2006
Last updated
04/08/2014
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