| NPI | 1336509348 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KERRI FAITH WORMWOOD Clinical Counselor And Art Therapis 505-604-1222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NM 1129) |
| Additional Taxonomies | 221700000X Art Therapist (Licence: NM 1128) |
| Enumeration Date | 2016-03-03 |
| Last Update Date | 2016-03-03 |