| NPI | 1255700787 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA BREMER QUINTANA Owner 505-453-5089 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NM C-09193) |
| Enumeration Date | 2015-09-15 |
| Last Update Date | 2017-02-22 |