Provider Demographics
NPI:1790418499
Name:RASP, ROBERT R
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:R
Last Name:RASP
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1415 COUNTRY CLUB CIR
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88001-1553
Mailing Address - Country:US
Mailing Address - Phone:314-359-0875
Mailing Address - Fax:
Practice Address - Street 1:1415 COUNTRY CLUB CIR
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88001-1553
Practice Address - Country:US
Practice Address - Phone:314-359-0875
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-08
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0044221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical