| NPI | 1821305244 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROXANNE D PRATT Clinical Director 505-301-1899 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NM 0125261) |
| Enumeration Date | 2010-09-07 |
| Last Update Date | 2012-09-04 |