Individual
JAMES MICHEAL MASH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
413 SIPAPU ROAD, TAOS, NM 87571
(505) 758-5857
(505) 758-2832
Mailing address
PO BOX 292, TAOS, NM 87571
(505) 751-1889
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
609
NM
103TP0016X
Prescribing (Medical) Psychologist
Primary
0013C
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
63236079
—
NM
Enumeration date
05/10/2006
Last updated
01/10/2008
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