Provider Demographics
NPI:1649523986
Name:PFAFF, ROBIN TAYLOR (EDD)
Entity type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:TAYLOR
Last Name:PFAFF
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1090
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88004-1090
Mailing Address - Country:US
Mailing Address - Phone:575-523-2288
Mailing Address - Fax:575-523-2299
Practice Address - Street 1:3050 N ROADRUNNER PKWY STE A
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-0846
Practice Address - Country:US
Practice Address - Phone:575-523-2288
Practice Address - Fax:575-523-2299
Is Sole Proprietor?:No
Enumeration Date:2012-10-24
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2087101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional