Provider Demographics
NPI:1629874037
Name:ATTERTON, ROBIN
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:ATTERTON
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:
Other - Last Name:ATTERTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:321 COMMERCE WAY
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:NM
Mailing Address - Zip Code:88101-4750
Mailing Address - Country:US
Mailing Address - Phone:575-935-6262
Mailing Address - Fax:
Practice Address - Street 1:300 COMMERCE WAY
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:NM
Practice Address - Zip Code:88101-4751
Practice Address - Country:US
Practice Address - Phone:575-935-6262
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-25
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
SEC-62-003973-2023171M00000X
NMSEC-62-003973-2023225XM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XM0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator