Provider Demographics
NPI:1740834795
Name:MUNOZ, ROSA E (PHD)
Entity type:Individual
Prefix:DR
First Name:ROSA
Middle Name:E
Last Name:MUNOZ
Suffix:
Gender:
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 UNSER BLVD NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87121-1927
Mailing Address - Country:US
Mailing Address - Phone:505-925-4126
Mailing Address - Fax:
Practice Address - Street 1:231 SIERRA DR SE STE 2
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87108-5633
Practice Address - Country:US
Practice Address - Phone:575-737-8717
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-29
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMPSY1565103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical