NPI Profile for ROBERT K WAATSA in ZUNI, NM.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Mental Health |
101YM0800X | |||
Addiction (Substance Use Disorder) |
101YA0400X |
| NPI # | 1003154170 |
|
| Status | Active | |
| Credentials | L.P.C.C., L.A.D.A.C. | |
| Entity | Individual | |
| Enumeration date | 01/24/2013 | |
| Last updated | 02/17/2021 - About 5 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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ROBERT K WAATSA
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