| NPI | 1417438110 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH EHLEN Registered Agent 505-273-3282 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NM 0182531) |
| Enumeration Date | 2018-08-22 |
| Last Update Date | 2018-08-22 |