Provider Demographics
NPI:1588311302
Name:SULAIMON, ASS'YAH QUEEN (MSW)
Entity type:Individual
Prefix:
First Name:ASS'YAH
Middle Name:QUEEN
Last Name:SULAIMON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5320 LUCILLE DR NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-1938
Mailing Address - Country:US
Mailing Address - Phone:505-920-2374
Mailing Address - Fax:
Practice Address - Street 1:1721 GIRARD BLVD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-1718
Practice Address - Country:US
Practice Address - Phone:505-318-0251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-02
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker