Individual
DAVID LONGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
405 N DATE ST, TRUTH OR CONSEQUENCES, NM 87901-2377
(575) 894-7589
(575) 894-7584
Mailing address
405 N DATE ST, TRUTH OR CONSEQUENCES, NM 87901-2377
(575) 894-7589
(575) 894-7584
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
344809
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
344809
SCHOOL PSYCHOLOGIST LICENSE
NM
Enumeration date
09/25/2014
Last updated
09/25/2014
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