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1417174848
PHYLLIS PINE
GALLUP, NM
NPI
1417174848
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
103TS0200X Psychologist, School
(Licence: NM 257139)
Enumeration Date
2007-04-19
Last Update Date
2007-07-08
Business Address
Ms. PHYLLIS PINE
1000 E AZTEC AVE
GALLUP, NM 87301-5509
Phone number: 505-721-1800
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Mailing Address
Ms. PHYLLIS PINE
222 NIZHONI BLVD APT E4
GALLUP, NM 87301-5764
Phone number: 505-793-2727
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