Provider Demographics
NPI:1265516744
Name:HASBROOK, ROSLYN S (LISW)
Entity type:Individual
Prefix:MRS
First Name:ROSLYN
Middle Name:S
Last Name:HASBROOK
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:MS
Other - First Name:ROSLYN
Other - Middle Name:S
Other - Last Name:LAWTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LISW
Mailing Address - Street 1:PO BOX 44867
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87174-4867
Mailing Address - Country:US
Mailing Address - Phone:505-994-1661
Mailing Address - Fax:505-994-1622
Practice Address - Street 1:2006 SOUTHERN BLVD
Practice Address - Street 2:SUITE 204
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124-2006
Practice Address - Country:US
Practice Address - Phone:505-994-1661
Practice Address - Fax:505-994-1622
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMI06521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical