Individual
CARMEN C FERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
700 FRIEDMAN AVE, LAS VEGAS, NM 87701-4231
(505) 454-5100
Mailing address
700 FRIEDMAN AVE, LAS VEGAS, NM 87701-4231
(505) 454-5100
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0839
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
93834861
—
NM
Enumeration date
08/31/2006
Last updated
07/08/2007
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