| NPI | 1902197098 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN M COBB Owner 575-622-6437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TP0016X Psychologist, Prescribing (Medical) (Licence: NM 0005) |
| Enumeration Date | 2011-04-25 |
| Last Update Date | 2011-04-25 |