Organization
INETMED RX2 INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PATTIJO N VELASQUEZ PHD, MSCP (COO)
(575) 636-2506
Entity
Organization
Contact information
Practice address
1505 S DON ROSER DR, SUITE A, LAS CRUCES, NM 88011-4596
(575) 636-2506
(575) 288-2691
Mailing address
1505 S DON ROSER DR, SUITE A, LAS CRUCES, NM 88011-4596
(575) 636-2506
(575) 288-2691
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1278
NM
103G00000X
Clinical Neuropsychologist
1278
NM
103T00000X
Psychologist
1278
NM
103TB0200X
Cognitive & Behavioral Psychologist
1278
NM
103TC0700X
Clinical Psychologist
1278
NM
103TC2200X
Clinical Child & Adolescent Psychologist
1278
NM
103TH0004X
Health Psychologist
1278
NM
103TP0016X
Prescribing (Medical) Psychologist
Primary
1278
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06035710
—
NM
Enumeration date
07/27/2016
Last updated
05/12/2017
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