| NPI | 1215557194 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY ELIZABETH KLOTZ Psychologist 505-449-7209 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2020-04-21 |
| Last Update Date | 2021-01-22 |