| NPI | 1407123789 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK OVRICK Licensed Independent Social Worker 575-937-5643 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NM I-05300) |
| Enumeration Date | 2011-11-30 |
| Last Update Date | 2011-11-30 |