| NPI | 1659870525 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLIE ANN TOMLIN Owner 505-926-1575 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NM C-10230) |
| Enumeration Date | 2018-02-06 |
| Last Update Date | 2018-02-06 |