Provider Demographics
NPI:1346961083
Name:ROBERTS, FAITH ELIZABETH
Entity Type:Individual
Prefix:
First Name:FAITH
Middle Name:ELIZABETH
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:809 W AVENUE C
Mailing Address - Street 2:
Mailing Address - City:LOVINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:88260-4344
Mailing Address - Country:US
Mailing Address - Phone:575-390-6968
Mailing Address - Fax:
Practice Address - Street 1:800 N JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:HOBBS
Practice Address - State:NM
Practice Address - Zip Code:88240-5332
Practice Address - Country:US
Practice Address - Phone:575-390-6968
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-12
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist