| NPI | 1841688272 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS STEPHEN SOUTHERN Psychologist/Owner 575-420-1853 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NM 1353) |
| Enumeration Date | 2015-01-08 |
| Last Update Date | 2018-03-17 |