Palmer, Deryl W
Palmer, Deryl W is an individual health care provider with primary practice located at 2000 E Lohman Ave Ste C , Las Cruces NM 88001-3100. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / School, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Palmer, Deryl W can be contacted via phone (575) 523-2288.Contact Information
Primary practice address
2000 E Lohman Ave Ste C
Las Cruces NM 88001-3100
Phone: (575) 523-2288
Fax: (575) 523-2299
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / School | 1041S0200X | M05423 | New Mexico |
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | I-06859 | New Mexico |
Profile Details
| NPI number | 1740317015 |
|---|---|
| LBN Legal business name | Palmer, Deryl W |
| Credentials | LISW |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 27th, 2007 |
| Last updated | Jun 30th, 2011 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1740317015 | NPPES |
| New Mexico | MEDICAID | 26782341 |
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