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Individual

ROBERT MURRAY WASSERMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMSW

Contact information

Practice address
203 W MAIN ST, FARMINGTON, NM 87401-4210
(970) 729-1178
Mailing address
P.O. BOX 1634, DURANGO, CO 81302
(970) 729-1178

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
104100000X
Social Worker
M-10625
NM
104100000X
Social Worker
Primary
X-11676
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1619475944
BCBS
NM
Enumeration date
02/01/2018
Last updated
09/22/2021
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