| NPI | 1013308691 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY WALKER Clinical Social Worker 505-974-9647 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2015-02-18 |
| Last Update Date | 2015-05-28 |