NPI 1003065749

Martin Nicholas Ancona, PHD

Practitioner Prescribing (Medical) Psychologist Chaparral, NM

Practice location

Address: 320 McCombs Rd STE C, Chaparral, NM 88081-7937
Phone: (575) 882-5100
Fax: (575) 882-1151
Mailing address: 785 Anthony Drive, Anthony, NM 88021-9747

Registered specialties (3)

Prescribing (Medical) Psychologist Primary

Behavioral Health & Social Service Providers Taxonomy 103TP0016X Licence 0040C (NM)

Other Psychologist providers in New Mexico →

Psychologist

Behavioral Health & Social Service Providers Taxonomy 103T00000X Licence PY60201752 (WA)

Clinical Psychologist

Behavioral Health & Social Service Providers Taxonomy 103TC0700X Licence 1296 (NM)

Registry record

NPI: 1003065749
Entity type: Individual
Sex (as registered): Male
NPI issued: 18 Sep 2008
Record last updated: 28 Feb 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.