| NPI | 1497397236 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | ABRAHAM LOPEZ Psyd 915-412-8751 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist | 
| Additional Taxonomies | 103TC0700X Psychologist, Clinical | 
| Enumeration Date | 2019-10-14 | 
| Last Update Date | 2022-04-25 |