Provider Demographics
NPI:1285654707
Name:WINSLOW, DONNA J (PHD)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:J
Last Name:WINSLOW
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6159
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88006-6159
Mailing Address - Country:US
Mailing Address - Phone:575-521-5370
Mailing Address - Fax:575-521-5376
Practice Address - Street 1:2450 S TELSHOR BLVD
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-5069
Practice Address - Country:US
Practice Address - Phone:575-521-5370
Practice Address - Fax:575-521-5376
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1313103TC0700X
NMPSY-RXP0057103TP0016X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TP0016XBehavioral Health & Social Service ProvidersPsychologistPrescribing (Medical)
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6000678Medicaid
NC046HTOtherBCBS NC
NC6000678Medicaid