| NPI | 1437848215 |
|---|---|
| Doing Business As | PRIVATE PRACTICE |
| Entity Type | Organization |
| Authorized Contact | STACEY ELLA KUNTZ Psychotherapist 505-357-7381 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2023-05-05 |
| Last Update Date | 2023-05-05 |