| NPI | 1316449119 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILIP TATORIS Psychotherapist 505-717-1332 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 104100000X Social Worker | |
| Enumeration Date | 2018-03-07 |
| Last Update Date | 2018-03-07 |