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Individual

MR. WILLIAM WALLACE RAABE II

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LADAC

Contact information

Practice address
3821 W COLLEGE LN, HOBBS, NM 88242-9126
(575) 392-2231
(575) 392-6484
Mailing address
3821 W COLLEGE LN, HOBBS, NM 88242-9126
(575) 392-2231
(575) 392-6484

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0103031
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000463000
NM
01
800521083
MEDICARE GROUP NUMBER
NM
Enumeration date
02/10/2009
Last updated
02/10/2009
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