Individual
ROBERT J LOUIS II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.A.
Contact information
Practice address
310 E MESA AVE, GALLUP, NM 87301-6147
(505) 979-6102
(505) 863-6103
Mailing address
503 BURKE DR, GALLUP, NM 87301-5461
(505) 979-6102
(505) 863-6103
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0118711
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
19683537
—
NM
Enumeration date
05/16/2007
Last updated
06/09/2015
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