| NPI | 1881421931 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOU DURAN Credentialing And Billing 505-270-3966 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2024-09-13 |
| Last Update Date | 2024-12-20 |