| NPI | 1841907094 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOAN PHAN Licenced Profess Clinical Counselor 505-227-7623 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Enumeration Date | 2022-10-27 |
| Last Update Date | 2025-01-20 |