Individual
DR. TOMAS REFUGIO GRANADOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
7000 JEFFERSON ST NE, ALBUQUERQUE, NM 87109-4313
(505) 797-0810
(505) 797-0814
Mailing address
PO BOX 93874, ALBUQUERQUE, NM 87199-3874
(505) 797-0810
(505) 797-0814
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
702
NM
103TC0700X
Clinical Psychologist
702
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201011548
CLINICAL PSYCHOLOGY
NM
01
—
NM00JP49
CLINICAL PSYCHOLOGY
NM
05
—
S8524
—
NM
Enumeration date
05/08/2007
Last updated
07/07/2009
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