| NPI | 1598288417 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN DAVID BOLDT Managing Member 575-639-1649 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2017-07-23 |
| Last Update Date | 2024-04-10 |