| NPI | 1396950390 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERNESTO FELIX SANTISTEVAN Clinical Director 505-577-2607 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NM 688) |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2015-07-31 |