| NPI | 1568998029 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MISTY DAWN DIAZ Office Administrator 505-327-0002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2017-05-03 |
| Last Update Date | 2023-12-29 |