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Individual

MR. ROBERT K. WAATSA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
L.P.C.C., L.A.D.A.C.

Contact information

Practice address
20 RT 301 NORTH, ZUNI, NM 87327
(505) 782-5719
(505) 782-5735
Mailing address
PO BOX 339, ZUNI, NM 87327-0339
(505) 782-5719
(505) 782-5735

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0159721
NM
101YM0800X
Mental Health Counselor
0156201
NM
101YM0800X
Mental Health Counselor
Primary
CCMH0208201
NM

Other

Enumeration date
01/24/2013
Last updated
02/17/2021
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