Healthcare Provider Details

I. General information

NPI: 1295285567
Provider Name (Legal Business Name): ROBYN E. ADMIRE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2016
Last Update Date: 08/03/2023
Certification Date: 08/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1776 MONTANO RD NW BLDG 3
LOS RANCHOS NM
87107-3248
US

IV. Provider business mailing address

PO BOX 6811
ALBUQUERQUE NM
87197-6811
US

V. Phone/Fax

Practice location:
  • Phone: 505-738-3698
  • Fax:
Mailing address:
  • Phone: 505-738-3698
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC-10721
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: