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Individual

DR. PETER NORMAN SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PSYD

Contact information

Practice address
101 LIVINGSTON LOOP STE 1, SANTA TERESA, NM 88008-9753
(505) 506-2546
(575) 201-7070
Mailing address
60 BEACH ST, SOUTH PORTLAND, ME 04106-1607
(505) 506-2546
(575) 201-7070

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
1290
NM
103TP0016X
Prescribing (Medical) Psychologist
0039C
NM
103TP0016X
Prescribing (Medical) Psychologist
Primary
PSY-RXP0053
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1290
NM PSYCHOLOGIST
NM
05
22639560
NM
01
4320
BCIA-C
AZ
01
612352100
DOL FECA
AZ
01
E-1463
BCIAC-EEG
AZ
01
PSY-RXP0053
STATE OF NEW MEXICO BOARD OF PSYCHOLOGIST EXAMINERS
NM
Enumeration date
06/15/2007
Last updated
03/07/2023
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