Healthcare Provider Details

I. General information

NPI: 1649523986
Provider Name (Legal Business Name): ROBIN TAYLOR PFAFF ED.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2012
Last Update Date: 10/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3050 N ROADRUNNER PKWY STE A
LAS CRUCES NM
88011-0846
US

IV. Provider business mailing address

PO BOX 1090
LAS CRUCES NM
88004-1090
US

V. Phone/Fax

Practice location:
  • Phone: 575-523-2288
  • Fax: 575-523-2299
Mailing address:
  • Phone: 575-523-2288
  • Fax: 575-523-2299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2087
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: