Phyllis Pine is a School in Gallup, New Mexico. Phyllis Pine practices all healthcare services and medical treatments related to School. The NPI Number for Phyllis Pine is 1417174848. The last update date is 2007-07-08.
Phyllis Pine's current location address is 222 Nizhoni Blvd Apt E4, Gallup, New Mexico. You can contact this provider via phone number 5057932727. The mailing address for Phyllis Pine is 222 Nizhoni Blvd Apt E4, Gallup, New Mexico. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Phyllis Pine |
|---|---|
| Address | 222 Nizhoni Blvd Apt E4, Gallup, New Mexico |
| Phone Number | 5057932727 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1417174848 |
|---|---|
| Provider Enumeration Date | 2007-04-19 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 222 Nizhoni Blvd Apt E4 |
|---|---|
| City | Gallup |
| State | New Mexico (NM) |
| Post Code | 873015764 |
| Phone Number | 5057932727 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | School |
|---|---|
| Taxonomy | 103Ts0200X |
| Licence No | 257139 |
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Definition: A psychologist whose specialty is concerned with the science and practice of psychology with children, youth, families; learners of all ages; and the schooling process. The basic education and training of school psychologists prepares them to provide |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 47809876 | NM | -- |
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What is the unique 10-digit identification code issued to Phyllis Pine by the Centers for Medicare & Medicaid Services?
The Phyllis Pine has been assigned the NPI (National Provider Identifier) 1417174848 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you please share the complete physical location address where Phyllis Pine's facilities are situated?
The facilities of Phyllis Pine are physically located at the following address: 222 Nizhoni Blvd Apt E4, Gallup, NM, 873015764.
What is the Phyllis Pine's specialty and taxonomy code?
The Phyllis Pine's specialty is School, and the corresponding taxonomy code is 103Ts0200X.
On what date did the Phyllis Pine receive the assignment of its 1417174848 from the Centers for Medicare & Medicaid Services?
The Phyllis Pine was issued its 1417174848 by the Centers for Medicare & Medicaid Services on 2007-04-19.
When was the information regarding Phyllis Pine, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Phyllis Pine, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2007-07-08.
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