Individual
MR. RONALD J MALOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LADAC
Contact information
Practice address
213 N. 2ND STREET, RATON, NM 87740
(575) 445-9761
(575) 445-2887
Mailing address
RR 1 BOX 56A, SPRINGER, NM 87747-9703
(575) 483-2480
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
3757
NM
Other
Enumeration date
04/25/2006
Last updated
01/26/2015
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