| NPI | 1316391063 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN HAIGH Owner 505-412-7756 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: NM MD2013-0659) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NM 0168791) |
| 103TP0016X Psychologist Prescribing (Medical) (Licence: NM 688) | |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: NM MD2013-0659) | |
| Enumeration Date | 2016-04-19 |
| Last Update Date | 2017-04-26 |