| NPI | 1316751514 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBBIE OFTEDAL Senior Management/Quality Control 505-289-7790 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) |
| 103TC0700X Psychologist, Clinical | |
| 103TF0000X Psychologist, Family | |
| Enumeration Date | 2025-02-06 |
| Last Update Date | 2025-02-06 |