| NPI | 1275216384 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA GALLEGOS Owner/Clinician 505-633-0733 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2023-08-08 |
| Last Update Date | 2023-08-08 |