Provider Demographics
NPI:1720307143
Name:SYED, RUBINA (MSW, LISW)
Entity type:Individual
Prefix:
First Name:RUBINA
Middle Name:
Last Name:SYED
Suffix:
Gender:F
Credentials:MSW, LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5220 OLD ADOBE TRL NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87120-2780
Mailing Address - Country:US
Mailing Address - Phone:505-803-0344
Mailing Address - Fax:
Practice Address - Street 1:8120 LA MIRADA PL NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-1605
Practice Address - Country:US
Practice Address - Phone:505-332-4850
Practice Address - Fax:505-332-4951
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-25
Last Update Date:2010-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMI-066221041C0700X
MI68010711141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical