INDIGO DIAGNOSTICS LLC NPI 1043763972

NPI Information

NPI: 1043763972
Provider Name: INDIGO DIAGNOSTICS LLC
Classification: Psychologist - 103TB0200X
Entity Type: Organization

Specialization: Cognitive & Behavioral

Address:
HC 75 BOX 1198
RUTHERON, NM
ZIP 87551
Phone: (505) 699-5315
Get Directions

INDIGO DIAGNOSTICS LLC is a cognitive and behavioral psychologist in Rutheron, NM. The provider is a psychologist who reflects an experimental-clinical approach distinguished by use of principles of human learning and development and theories of cognitive processing to promote meaningful change in maladaptive human behavior and thinking. INDIGO DIAGNOSTICS LLC NPI is 1043763972. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

HC 75 BOX 1198
RUTHERON, NM
ZIP 87551-725
Phone: (505) 699-5315
Fax: (575) 588-0199

The provider's authorized official is Mariana Ulibarri Horan .
The authorized official title is Psycho Educational Diagnostician and has the following contact phone number (505) 699-5315.

The enumeration date for this NPI number is 7/27/2016 and was last updated on 7/27/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	103TM1800X	Psychologist	Intellectual and Developmental Disabilities	350792	NEW MEXICO	No
2	251300000X	Local Education Agency (LEA)		350792	NEW MEXICO	No
3	251B00000X	Case Management		350792	NEW MEXICO	No
4	251C00000X	Day Training, Developmentally Disabled Services		350792	NEW MEXICO	No
5	252Y00000X	Early Intervention Provider Agency		350792	NEW MEXICO	No
6	103TB0200X	Psychologist	Cognitive & Behavioral	350792	NEW MEXICO	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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