| NPI | 1073210316 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLAUDIA NARANJO Authorized Agent 915-256-9028 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TP0016X Psychologist, Prescribing (Medical) |
| Enumeration Date | 2023-02-07 |
| Last Update Date | 2023-03-23 |