| NPI | 1669691192 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARICELA OLIVAS Medicaid Coordinator 505-455-0801 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TS0200X Psychologist, School |
| Additional Taxonomies | 1041S0200X Social Worker, School |
| 225100000X Physical Therapist | |
| 225X00000X Occupational Therapist | |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2020-08-22 |