| NPI | 1023355252 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JILL M TIEDEMANN Team Leader 505-983-8502 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 1041S0200X Social Worker, School |
| Enumeration Date | 2013-01-08 |
| Last Update Date | 2016-06-09 |