| NPI | 1386069623 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JILL SOUTHAM Lpcc/Owner 575-639-0264 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NM 0159001) |
| Enumeration Date | 2014-02-24 |
| Last Update Date | 2014-02-24 |