| NPI | 1245403807 |
|---|---|
| Former Legal Business Name | EDWARD G. KRUIS, LPCC |
| Entity Type | Organization |
| Authorized Contact | EDWARD G KRUIS Owner 575-650-0071 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NM 0078221) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NM 0106801) |
| Enumeration Date | 2008-04-03 |
| Last Update Date | 2008-04-03 |