| NPI | 1114385952 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHERINE GENEVIEVE DAVIDGE Licensed Clinical Social Worker 505-830-6030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NM C-1853) |
| Enumeration Date | 2016-02-08 |
| Last Update Date | 2016-02-12 |