| NPI | 1265938203 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREN GOMEZ Psychotherapist 505-717-1332 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 104100000X Social Worker (Licence: NM C-06315) |
| Enumeration Date | 2018-03-30 |
| Last Update Date | 2024-12-13 |