| Doctor Name: | RON WALDEN |
| NPI Number: | 1003001744 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 2700 Farmington Ave Farmington, NM - 874014559 |
| Business Phone Number: | 5053267878 |
| Business Fax Number: | 5053267879 |
| Mailing Address: | 314 Hillcrest Dr Apt B, DURANGO |
| State: | CO |
| Postal Code: | 813016582 |
| Phone Number: | 9079030580 |
| Fax Number: | |
| NPI Enumeration Date: | 09/06/2007 |
| NPI Last Update Date: | 09/21/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |