Organization
RIO GRANDE NEUROSCIENCE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JILL RYAN PH.D. (OWNER)
(505) 412-0545
Entity
Organization
Contact information
Practice address
600 CENTRAL AVE SE, SUITE 221, ALBUQUERQUE, NM 87102-3656
(505) 345-9288
(505) 212-0359
Mailing address
600 CENTRAL AVE SE, SUITE 221, ALBUQUERQUE, NM 87102-3656
(505) 345-9288
(505) 212-0359
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1147
NM
Other
Enumeration date
04/27/2015
Last updated
05/22/2015
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