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 |