Organization
RICARDO GONZALES, PH.D., PSYCHOLOGICAL SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICARDO R. GONZALES PH.D. (CLINICAL PSYCHOLOGIST)
(505) 757-2216
Entity
Organization
Contact information
Practice address
168 AVE. PONDEROSA, GLORIETA, NM 87535
(505) 757-2216
Mailing address
PO BOX 325, GLORIETA, NM 87535-0325
(505) 757-2216
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
#414
NM
261QM0855X
Adolescent and Children Mental Health Clinic/Center
#414
NM
Other
Enumeration date
03/20/2012
Last updated
04/02/2012
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