Individual
CAROL J FITZPATRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1232 APACHE AVE, SANTA FE, NM 87505-3255
(505) 424-9159
(505) 216-7595
Mailing address
1800 OLD PECOS TRL STE B, SANTA FE, NM 87505-4787
(505) 424-9159
(505) 216-7595
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0769
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201030542
PRESBYTERIAN HEALTH PLAN
NM
01
—
NM600536
VALUE OPTIONS
NM
Enumeration date
07/12/2006
Last updated
04/08/2010
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