Individual
MR. ROBERT COLLETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
12302 KENNEDY DR, PARKER, AZ 85344-7833
(928) 669-5243
Mailing address
2455 CAMINO LN, LAKE HAVASU CITY, AZ 86403-5825
(928) 453-0222
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
12469
AZ
1041C0700X
Clinical Social Worker
125
CO
1041C0700X
Clinical Social Worker
Primary
2002030046
MO
Other
Enumeration date
07/21/2009
Last updated
07/21/2009
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