Individual
ROBERT MAXWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LSAA
Contact information
Practice address
5016 LA BAJADA RD NW, ALBUQUERQUE, NM 87105-1560
(505) 344-6738
Mailing address
5016 LA BAJADA RD NW, ALBUQUERQUE, NM 87105-1560
(505) 831-9148
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LSAA #6022
NM
Other
Enumeration date
10/12/2006
Last updated
07/08/2007
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