| NPI | 1598573008 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TENNILLE MARRUJO-MOCTEZUMA Owner 575-644-2544 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-12-30 |
| Last Update Date | 2025-07-30 |