| NPI | 1669173035 |
|---|---|
| Doing Business As | BLACK CANVAS WHOLISTIC THERAPY |
| Entity Type | Organization |
| Authorized Contact | MAQUEITA S ELEAZER Owner 505-913-1641 |
| Organization Subpart ? | No |
| Primary Taxonomy | 221700000X Art Therapist |
| Additional Taxonomies | 101Y00000X Counselor |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| Enumeration Date | 2023-03-13 |
| Last Update Date | 2023-11-02 |