Individual
MARY EISELE CUMMINGS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
555 OPPENHEIMER DR, 200, LOS ALAMOS, NM 87544-2384
(505) 660-8284
(505) 672-3102
Mailing address
555 OPPENHEIMER DR, 200, LOS ALAMOS, NM 87544-2384
(505) 660-8284
(505) 672-3102
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
409
NM
Other
Enumeration date
07/27/2010
Last updated
07/27/2010
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