Individual
ROBERT WESLEY MCKINNIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA LPCC
Contact information
Practice address
3 ENCANTADO LOOP, SANTA FE, NM 87508
(505) 989-1313
Mailing address
3 ENCANTADO LOOP, SANTA FE, NM 87508
(505) 989-1313
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2969
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NM1101693
VALUE OPTIONS
NM
Enumeration date
12/06/2006
Last updated
07/08/2007
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