| NPI | 1467856401 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMERA KLOHN Medicaid Coordinator 505-334-3695 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041S0200X Social Worker, School (Licence: NM M-08762) |
| Enumeration Date | 2014-10-20 |
| Last Update Date | 2014-10-20 |