| NPI | 1891125183 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNE CANNON Owner 505-503-6800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NM 0084711) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NM 0112181) |
| 207Q00000X Family Medicine | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NM CNP-02033) | |
| Enumeration Date | 2013-11-22 |
| Last Update Date | 2023-10-13 |