| NPI | 1255780284 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAMEA JO GAGLIARDI Psychologist 505-331-7324 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CO PSYC.00013604) |
| Enumeration Date | 2016-06-09 |
| Last Update Date | 2016-06-09 |