| NPI | 1619001419 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN MICHAEL WESTBROOK Owner 575-393-0692 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor, Mental Health | |
| 103T00000X Psychologist | |
| 103TC0700X Psychologist, Clinical | |
| 104100000X Social Worker | |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2017-09-19 |