| NPI | 1447895651 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE GORMAN Neuropsychologist 505-450-7804 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2019-11-12 |
| Last Update Date | 2019-11-12 |