| NPI | 1407632383 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY PEREZ Office Manager/Biller 575-650-4357 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2023-09-06 |
| Last Update Date | 2023-09-19 |