Head, Wayne Keith
Head, Wayne Keith is an individual health care provider with primary practice located at 1600 Sutter Pl , Clovis NM 88101-4611. He recently has only one registered license in Behavioral Health & Social Service Providers / School, which is considered as his primary health care specialty. Head, Wayne Keith can be contacted via phone (505) 769-4490.Contact Information
Primary practice address
1600 Sutter Pl
Clovis NM 88101-4611
Phone: (505) 769-4490
Fax: (505) 935-0011
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / School | 1041S0200X | M1898 | New Mexico |
Profile Details
| NPI number | 1699844464 |
|---|---|
| LBN Legal business name | Head, Wayne Keith |
| Credentials | LMSW |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 7th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1699844464 | NPPES |
| New Mexico | MEDICAID | 000L3825 |
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