| NPI | 1598218190 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER BETH ROSE Sole Proprietor 505-639-1312 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NM I-06999) |
| Enumeration Date | 2016-07-29 |
| Last Update Date | 2024-09-04 |