Healthcare Provider Details

I. General information

NPI: 1609120195
Provider Name (Legal Business Name): BECKY URBINA LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/05/2012
Last Update Date: 05/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5803 ORGAN PEAK DR
LAS CRUCES NM
88012-7940
US

IV. Provider business mailing address

5803 ORGAN PEAK DR
LAS CRUCES NM
88012-7940
US

V. Phone/Fax

Practice location:
  • Phone: 575-650-5000
  • Fax:
Mailing address:
  • Phone: 575-650-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: