| NPI | 1326115049 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN HAROLD KING Director 505-404-9395 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TP0016X Psychologist, Prescribing (Medical) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: NM 0969) |
| 103TC0700X Psychologist, Clinical (Licence: NM 0969) | |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2021-05-27 |