| NPI | 1245987049 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY KATHLEEN MARTINEZ Owner/Authorized Official 505-573-3349 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2022-03-02 |
| Last Update Date | 2022-06-02 |