Individual
DR. WAYNE ROWAN MAES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
4813 CORRALES RD., CORRALES, NM 87048-0531
(505) 898-5662
(505) 898-5890
Mailing address
PO BOX 531, CORRALES, NM 87048-0531
(505) 898-5662
(505) 898-5890
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
266
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00NL86
BC/BS
NM
01
—
59651
PRESBYTERIAN HEALTH PLAN
NM
05
—
N8313
—
NM
Enumeration date
10/17/2006
Last updated
07/08/2007
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