| NPI | 1487091484 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DURANDA COSETTE MONTANEZ Licensed Psychologist 575-202-5167 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NM 0944) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NM 0944) |
| Enumeration Date | 2013-05-30 |
| Last Update Date | 2013-05-30 |