| NPI | 1073682357 |
|---|---|
| Doing Business As | MY HEALING SPACE |
| Entity Type | Organization |
| Authorized Contact | LOUIE C ATENCIO Therapist Owner 505-644-0399 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: NM I4400) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NM 0070621) |
| 101Y00000X Counselor (Licence: NM 0099031) | |
| 101Y00000X Counselor (Licence: NM 4313) | |
| 101Y00000X Counselor (Licence: NM 0100821) | |
| 251S00000X Community/Behavioral Health (Licence: NM 03 067732 00 7) | |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2008-07-15 |