INDIGO DIAGNOSTICS LLC, Cognitive & Behavioral RUTHERON, NM

Contact Information

INDIGO DIAGNOSTICS LLC

HC 75 BOX 1198
RUTHERON, NM 87551-9725

Phone: 505-699-5315
Fax: 575-588-0199
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Cognitive & Behavioral	103TB0200X	62	Psychologist, Clinical
Case Management	251B00000X
Day Training, Developmentally Disabled Services	251C00000X
Early Intervention Provider Agency	252Y00000X
Intellectual & Developmental Disabilities	103TM1800X	62	Psychologist, Clinical
Local Education Agency (LEA)	251300000X

Indicates primary specialty

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NPI Profile & details for INDIGO DIAGNOSTICS LLC · (Female)

NPI Number	`1043763972`
Status	Active
Credentials
Entity	Individual
Enumeration date	07/27/2016
Last updated	07/27/2016 - About 10 years ago
Sole proprietor ¹	Not specified
Identifiers	NM License # 350792
Hospital affiliation(s)	Not Available

¹ A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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