| NPI | 1124221635 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM SMITH Clinical Psychologist 505-884-8595 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NM 325) |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2020-08-22 |