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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. NICOLE PHOENIX ANDERSON, PHD

Active Sole Proprietor

DR. NICOLE PHOENIX ANDERSON, PHD is a Clinical Psychologist healthcare provider located in LOS RANCHOS, New Mexico. NPI 1730126343 is currently active in the NPPES registry. Verify at CMS.

Clinical Psychologist · LOS RANCHOS, NM

Registration Details

NPI Number
1730126343
Provider Type
Individual
Gender
Female
NPI Issued
Jun 1, 2006 (20.163320349808 yrs)
Last Updated
Jun 20, 2014
License
0976 (NM)
Sole Proprietor
Yes

Practice Information

Address
6501 4TH ST NW
F4
LOS RANCHOS, NM, 871075800
Browse NM providers · Browse ZIP 87107
Phone
5053449641
Fax
5053442621
Primary Specialty
Clinical Psychologist
103TC0700X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.