Individual
MS. MARYLIN JEAN WATTEYNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW-LCSW
Contact information
Practice address
1222 HIGHWAY 485, JEMEZ PUEBLO, NM 87024-9709
(575) 834-2413
Mailing address
1222 HIGHWAY 485, JEMEZ PUEBLO, NM 87024-9709
(575) 834-2413
(575) 834-2413
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
10/13/2015
Last updated
10/13/2015
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