| NPI | 1154869873 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VALERIE A BURGELIN Owner 575-888-0100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2017-02-01 |
| Last Update Date | 2023-01-27 |