| NPI | 1932437647 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONIKA PETERSON Clinical Psychologist 505-350-7160 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NM 1093) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: NM 0121881) |
| Enumeration Date | 2009-11-19 |
| Last Update Date | 2009-11-19 |