Individual
MICHAEL A FRAGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
1717 W 2ND ST, ROSWELL, NM 88201-2000
(575) 623-1220
Mailing address
3015 MISSION ARCH DR, ROSWELL, NM 88201-8304
(707) 494-1303
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
1041
NM
Other
Enumeration date
01/30/2006
Last updated
09/09/2020
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