| NPI | 1780385849 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA MARIE MENDOZA Owner & Director 505-231-8578 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2023-03-15 |
| Last Update Date | 2023-10-30 |