Organization
SUN & MOON PSYCHOLOGICAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMANTHA RUSSELL PHD (PSYCHOLOGIST)
(505) 221-6611
Entity
Organization
Contact information
Practice address
12760 SAN RAFAEL AVE NE STE D, ALBUQUERQUE, NM 87122-1133
(505) 221-6611
Mailing address
6601 TENNYSON ST NE APT 3103, ALBUQUERQUE, NM 87111-8204
(970) 471-3981
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
01/09/2023
Last updated
01/09/2023
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