NPI | 1487910402 |
---|---|
Entity Type | Organization |
Authorized Contact | LAUREN PARKS Director 505-490-9049 |
Organization Subpart ? | No |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: NM 1183) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NM 1183) |
Enumeration Date | 2012-04-03 |
Last Update Date | 2016-08-11 |