Individual
ROBIN L BLACKWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW
Contact information
Practice address
4810 HARDWARE DR NE, ALBUQUERQUE, NM 87109
(505) 440-9303
Mailing address
4810 HARDWARE DR NE, PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87109-2013
(505) 440-9303
(505) 255-4717
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
I-05040
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
71828575
—
NM
Enumeration date
11/10/2006
Last updated
02/14/2017
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