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Individual

MS. LINDA MIKA MENDE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
714 CALLE DON DIEGO, ESPANOLA PUBLIC SCHOOLS, ESPANOLA, NM 87532
(505) 753-2254
Mailing address
941 CALLE MEJIA APT 805, SANTA FE, NM 87501-1466
(301) 442-4225

Taxonomy

Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
2054
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2054
MARYLAND EDUCATOR CERTIFICATE: ADVANCED PROF CERTIFICATE - SCHOOL PSYCHOLOGIST
01
352581
STATE OF NEW MEXICO SCHOOL PERSONNEL LICENSE - L1 PREK-12 SCHOOL PSYCHOLOGIST
NM
01
35678
NATIONALLY CERTIFIED SCHOOL PSYCHOLOGIST
Enumeration date
10/17/2012
Last updated
11/19/2012
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