Provider Demographics
NPI:1346454840
Name:RABER, KRISTIN MARIA (MSW)
Entity Type:Individual
Prefix:MS
First Name:KRISTIN
Middle Name:MARIA
Last Name:RABER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2175 37TH ST APT A
Mailing Address - Street 2:
Mailing Address - City:LOS ALAMOS
Mailing Address - State:NM
Mailing Address - Zip Code:87544-2498
Mailing Address - Country:US
Mailing Address - Phone:505-662-0668
Mailing Address - Fax:
Practice Address - Street 1:555 OPPENHEIMER DR
Practice Address - Street 2:SUITE 200
Practice Address - City:LOS ALAMOS
Practice Address - State:NM
Practice Address - Zip Code:87544-2384
Practice Address - Country:US
Practice Address - Phone:505-660-4383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMI-33231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical