| NPI | 1487107363 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATTIJO N VELASQUEZ COO 575-636-2506 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TP0016X Psychologist, Prescribing (Medical) (Licence: NM 1278) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NM 1278) |
| 103G00000X Clinical Neuropsychologist (Licence: NM 1278) | |
| 103T00000X Psychologist (Licence: NM 1278) | |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: NM 1278) | |
| 103TC0700X Psychologist, Clinical (Licence: NM 1278) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NM 1278) | |
| 103TH0004X Psychologist, Health (Licence: NM 1278) | |
| Enumeration Date | 2016-07-27 |
| Last Update Date | 2017-05-12 |