| NPI | 1124211404 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVE MARTINEZ Interim Administrator 505-454-2203 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TP0814X Psychologist Psychoanalysis |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| Enumeration Date | 2007-08-21 |
| Last Update Date | 2007-08-21 |