| Juanita Waites Psychological Services, Inc. | |
|
905 Main St Ste 502 Klamath Falls OR 97601-6062 | |
| (541) 331-3152 | |
| (833) 263-0939 |
| Full Name | Juanita Waites Psychological Services, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 905 Main St Ste 502, Klamath Falls, Oregon |
| Authorized Official Name and Position | Juanita Marie Waites (PRESIDENT) |
| Authorized Official Contact | 5413313152 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Juanita Waites Psychological Services, Inc. 2384 Linda Vista Dr Apt 3 Klamath Falls OR 97601-2300 Ph: (541) 331-3152 | Juanita Waites Psychological Services, Inc. 905 Main St Ste 502 Klamath Falls OR 97601-6062 Ph: (541) 331-3152 |
| NPI Number | 1851862718 |
|---|---|
| Provider Enumeration Date | 12/17/2018 |
| Last Update Date | 12/17/2018 |
| Medicare PECOS PAC ID | 9638565245 |
|---|---|
| Medicare Enrollment ID | O20220513000664 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851862718 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Juanita Marie Waites |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1861705485 PECOS PAC ID: 3476949082 Enrollment ID: I20220513000770 |
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