Organization
HIGH PLAINS NEUROPSYCHOLOGY ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GERALD RUSSELL (CLINICAL NEUROPSYCHOLOGIST)
(505) 429-4679
Entity
Organization
Contact information
Practice address
1101 DOUGLAS AVE, LAS VEGAS, NM 87701-3932
(505) 429-4679
Mailing address
PO BOX 1705, LAS VEGAS, NM 87701-1705
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
761
NM
Other
Enumeration date
02/10/2010
Last updated
03/11/2011
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