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Individual

ROBBIE R DANIELS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LADAC

Contact information

Practice address
516 E. NIZHONI BLVD., GALLUP, NM 87301-1337
(505) 722-1000
(505) 722-1396
Mailing address
PO BOX 1337, GALLUP, NM 87305-1337
(505) 722-1000
(505) 722-1396

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
3454
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00067267
NM
Enumeration date
06/22/2006
Last updated
04/11/2008
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