| NPI | 1124530969 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE RENEE BORSBERRY Owner 915-549-5257 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: NM 0174291) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2017-11-02 |
| Last Update Date | 2021-03-09 |