| NPI | 1316291792 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACEY LUNA Owner 575-420-9380 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NM CNP-02032) |
| Enumeration Date | 2012-11-06 |
| Last Update Date | 2018-01-24 |