Provider Demographics
NPI:1891136412
Name:RYMBERG, SHULAMIT (LMSW)
Entity type:Individual
Prefix:
First Name:SHULAMIT
Middle Name:
Last Name:RYMBERG
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:SHEILA
Other - Middle Name:
Other - Last Name:WRIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3209 N WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:NM
Mailing Address - Zip Code:88201-5271
Mailing Address - Country:US
Mailing Address - Phone:575-914-3484
Mailing Address - Fax:575-627-6339
Practice Address - Street 1:1010 N VIRGINIA AVE
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:NM
Practice Address - Zip Code:88201-5126
Practice Address - Country:US
Practice Address - Phone:575-623-9322
Practice Address - Fax:575-627-6339
Is Sole Proprietor?:No
Enumeration Date:2013-07-11
Last Update Date:2013-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMM-2339104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker