| NPI | 1750451746 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN KEITH WHITLOCK Chief Psychologist 505-623-9322 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TH0100X Psychologist, Health Service (Licence: NM 0966) |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2020-08-22 |