| NPI | 1891331773 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA L LEDEZMA-CHINCHILLA Clinical Counselor 505-417-3824 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Enumeration Date | 2019-11-26 |
| Last Update Date | 2020-03-18 |