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Individual

ROBINSON TOM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
COUNSELOR

Contact information

Practice address
.5 MILES OFF HWY371, .5 MILES OFF HWY371, THOREAU, NM 87323-1289
(505) 905-0061
(505) 905-0064
Mailing address
PO BOX 1289, THOREAU, NM 87323-1289
(505) 905-0061
(505) 905-0064

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
860092335
BEHAVIORAL HEALTH SERVICE
NM
Enumeration date
05/24/2011
Last updated
05/24/2011
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