Individual
ROBERT E MOSLOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LISW
Contact information
Practice address
5901 HARPER DR NE, PMG NORTHSIDE, ALBUQUERQUE, NM 87109
(505) 823-8888
(505) 823-8275
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-5356
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
103TP0814X
Psychoanalysis Psychologist
Primary
I-3046
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000N3879
—
NM
Enumeration date
03/05/2007
Last updated
08/15/2008
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