| NPI | 1891245189 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAGGIE PROVENCIO CFO 575-526-6682 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225X00000X Occupational Therapist | |
| Enumeration Date | 2016-10-11 |
| Last Update Date | 2026-09-02 |