Wyckoff-Fish, Patty

Wyckoff-Fish, Patty is an individual health care provider with primary practice located at 1211 Hawaii Ave , Alamogordo NM 88310-6437. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / School. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Wyckoff-Fish, Patty can be contacted via phone (505) 439-3200.

Contact Information

Primary practice address
1211 Hawaii Ave Alamogordo NM 88310-6437
Phone: (505) 439-3200
Fax: (505) 434-1840
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X I-04645 New Mexico
Behavioral Health & Social Service Providers / School 1041S0200X 264414 New Mexico

Profile Details

NPI number 1811079239
LBN Legal business name Wyckoff-Fish, Patty
Credentials LISW
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 19th, 2006
Last updated Jul 8th, 2007 - about 18 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811079239 NPPES
New Mexico MEDICAID 57276099

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