| NPI | 1891267605 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIANE HILLOCK Principal 505-722-8922 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| 235Z00000X Speech-Language Pathologist | |
| Enumeration Date | 2018-12-19 |
| Last Update Date | 2018-12-19 |