| NPI | 1275804213 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL J GALLEGOS Psychologist 505-268-1456 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NM 0816) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: TX 25095) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NM 0816) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: TX 25095) | |
| 103TF0000X Psychologist, Family (Licence: NM 0816) | |
| 103TF0000X Psychologist, Family (Licence: TX 25095) | |
| 103TS0200X Psychologist, School (Licence: TX 30083) | |
| 103TS0200X Psychologist, School (Licence: NM 302062) | |
| Enumeration Date | 2012-01-23 |
| Last Update Date | 2012-01-23 |