Organization
ELIZABETH PENLAND PHD
Active
Organization
ELIZABETH PENLAND PHD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELIZABETH A PENLAND PH.D. (LICENSED PSYCHOLOGIST)
(505) 896-3444
Entity
Organization
Contact information
Practice address
4011 BARBARA LOOP SE, STE 207, RIO RANCHO, NM 87124-1039
(505) 896-3444
(505) 994-9194
Mailing address
4011 BARBARA LOOP SE, STE 207, RIO RANCHO, NM 87124-1039
(505) 896-3444
(505) 994-9194
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0709
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NM101550
—
NM
01
—
NMB2417
MEDICARE PTAN
NM
Enumeration date
04/08/2015
Last updated
04/08/2015
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