| NPI | 1902773799 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PENNIE L MATHIAS Occupational Therapist 505-269-2325 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225XP0200X Occupational Therapist Pediatrics |
| Enumeration Date | 2025-10-17 |
| Last Update Date | 2025-10-17 |