| NPI | 1447579487 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLAN RAY ROBERTS President 505-312-7070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TP0016X Psychologist, Prescribing (Medical) (Licence: NM 0043) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA PSY13524) |
| 103TC0700X Psychologist, Clinical (Licence: NM 1255) | |
| Enumeration Date | 2010-05-28 |
| Last Update Date | 2016-09-29 |