Healthcare Provider Details

I. General information

NPI: 1013677111
Provider Name (Legal Business Name): NEGIN BABADI LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/30/2021
Last Update Date: 12/30/2021
Certification Date: 12/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1313 MISSION AVE.
FARMINGTON NM
87401-8740
US

IV. Provider business mailing address

PO BOX 1830
FARMINGTON NM
87499-1830
US

V. Phone/Fax

Practice location:
  • Phone: 505-327-7218
  • Fax:
Mailing address:
  • Phone: 505-327-7218
  • Fax: 505-327-0828

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberX-12193
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: