Provider Demographics
NPI:1619011244
Name:DUNCAN, ROBERT L (PHD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:L
Last Name:DUNCAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5200 COPPER AVE NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87108-1473
Mailing Address - Country:US
Mailing Address - Phone:505-255-5099
Mailing Address - Fax:505-255-4206
Practice Address - Street 1:5200 COPPER AVE NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87108-1473
Practice Address - Country:US
Practice Address - Phone:505-255-5099
Practice Address - Fax:505-255-4206
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2007-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM131103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool