| NPI | 1578602413 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GILBERT E JIMENEZ Clinical Therapist 505-317-5101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: NM LPCC005511) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: NM LMFT4794) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2020-08-22 |