| NPI | 1518600048 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN GREENBERG Director 505-636-6550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TH0100X Psychologist Health Service |
| Additional Taxonomies | 102L00000X Psychoanalyst |
| 103TA0700X Psychologist Adult Development & Aging | |
| 103TC0700X Psychologist Clinical | |
| 103TP0814X Psychologist Psychoanalysis | |
| 261QM0850X Clinic/Center Adult Mental Health | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2022-04-13 |
| Last Update Date | 2022-04-13 |