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Organization

CHILD & FAMILY WELLNESS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KAREN RABURN MD (OWNER)
(505) 793-5547
Entity
Organization

Contact information

Practice address
1601 E 20TH ST, FARMINGTON, NM 87401-4307
(505) 793-5547
Mailing address
1601 E 20TH ST, FARMINGTON, NM 87401-4307
(505) 793-5547

Taxonomy

Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
96388
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1881726388
SINGLE PROVIDER NPI
NM
Enumeration date
06/06/2008
Last updated
07/01/2008
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