Priscilla Roth-Wall in Farmington - Clinical Child & Adolescent

Priscilla Roth-Wall - NPI 1457386963

Priscilla Roth-Wall is a Clinical Child & Adolescent in Farmington, New Mexico. Priscilla Roth-Wall practices all healthcare services and medical treatments related to Clinical Child & Adolescent. The NPI Number for Priscilla Roth-Wall is 1457386963. The last update date is 2020-04-30.

Priscilla Roth-Wall's current location address is 3751 N Butler Ave Ste 115, Farmington, New Mexico. You can contact this provider via phone number 5057872640 and fax number 5057872789. The mailing address for Priscilla Roth-Wall is 3751 N Butler Ave Ste 115, Farmington, New Mexico. To know further, please read the information below!

Provider Profile Detail

Provider Name Priscilla Roth-Wall
Address 3751 N Butler Ave Ste 115, Farmington, New Mexico
Phone Number 5057872640
Fax Number 5057872789
Sole Proprietor Y
Credentials PH.D.

NPI Number Detail

NPI Number 1457386963
Provider Enumeration Date 2006-07-12
Last Updated Date 2020-04-30

Provider Mailing Address Detail

Address 3751 N Butler Ave Ste 115
City Farmington
State New Mexico (NM)
Post Code 874016425
Phone Number 5057872640
Fax Number 5057872789

Provider's Primary Taxonomy Detail

Speciality Clinical Child & Adolescent
Taxonomy 103Tc2200X
Licence No PSY1470
Definition:
A psychologist who develops and applies scientific knowledge to the delivery of psychological services to infants, toddlers, children and adolescents within their social context. Of particular importance to the specialty of clinical child psychology

Provider's Other Legacy Identifiers

Identifier Identifier Type Identifier State Identifier Issuer
PSY1470 NM PSYCHOLOGY LICENSE
16970748 NM --
73763700 NM MAGELLAN

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FAQs about Priscilla Roth-Wall

What is the Priscilla Roth-Wall's unique identification number?

The Priscilla Roth-Wall has been assigned the NPI (National Provider Identifier) Number 1457386963 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.

Could you please provide the complete street address where Priscilla Roth-Wall is physically located?

The Priscilla Roth-Wall is physically situated at the following address: 3751 N Butler Ave Ste 115, Farmington, NM, 874016425.

What is Priscilla Roth-Wall's area of expertise and its corresponding taxonomy classification?

The Priscilla Roth-Wall's field of specialization is Clinical Child & Adolescent, and it falls under the taxonomy code 103Tc2200X, which categorizes healthcare providers based on their areas of practice.

On what date was the 1457386963 assigned to Priscilla Roth-Wall?

The Priscilla Roth-Wall was issued its 1457386963 on 2006-07-12, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.

When was the information regarding Priscilla Roth-Wall, such as address, specialty, and other details, most recently verified or confirmed to be accurate?

The information pertaining to Priscilla Roth-Wall, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2020-04-30.

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