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Individual

KIKI SHAWN WATO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
US HWY 491 NORTH, SHIPROCK, NM 87420
(505) 368-6001
(505) 368-7319
Mailing address
PO BOX 160, SHIPROCK, NM 87420-0160
(505) 368-6001
(505) 368-7319

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C-10805
NM

Other

Enumeration date
07/27/2016
Last updated
05/18/2021
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