Individual
MR. ROBERT H FERNANDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LADAC
Contact information
Practice address
MANULITO STREET BUILDING T006-013, BEHAVIORAL HEALTH SERVICES, TOHATCHI, NM 87325
(505) 733-2825
(505) 733-2829
Mailing address
PO BOX 609, TOHATCHI, NM 87325-0609
(505) 733-2825
(505) 733-2829
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
3524
NM
Other
Enumeration date
05/24/2007
Last updated
07/08/2007
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