Provider Demographics
NPI:1144742867
Name:ALBO, PATTY ANN (RBT)
Entity Type:Individual
Prefix:
First Name:PATTY
Middle Name:ANN
Last Name:ALBO
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7224 HEARTHSTONE RD NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87114-4584
Mailing Address - Country:US
Mailing Address - Phone:505-712-3029
Mailing Address - Fax:
Practice Address - Street 1:7224 HEARTHSTONE RD NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87114-4584
Practice Address - Country:US
Practice Address - Phone:505-712-3029
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-14
Last Update Date:2017-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM106S00000X
106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician