| NPI | 1518455245 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANETTE ELAINE CASTILLO Psychologist 575-527-0614 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NM 1107) |
| Enumeration Date | 2018-04-27 |
| Last Update Date | 2019-02-07 |