Individual
ROBERT RICHARD MAES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CAC III
Contact information
Practice address
279 S JOE MARTINEZ BLVD, SUITE A, PUEBLO WEST, CO 81007-5439
(719) 647-1787
(719) 647-1731
Mailing address
279 S JOE MARTINEZ BLVD, SUITE A, PUEBLO WEST, CO 81007-5439
(719) 647-1787
(719) 647-1731
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6520
—
CO
Enumeration date
01/03/2012
Last updated
01/03/2012
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