Healthcare Provider Details

I. General information

NPI: 1720060049
Provider Name (Legal Business Name): JANET KAY ROBINSON PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/14/2005
Last Update Date: 03/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 TULANE DR SE
ALBUQUERQUE NM
87106-1413
US

IV. Provider business mailing address

201 TULANE DR SE
ALBUQUERQUE NM
87106-1413
US

V. Phone/Fax

Practice location:
  • Phone: 505-206-7558
  • Fax:
Mailing address:
  • Phone: 505-206-7558
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberNM463
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: