| NPI | 1932650041 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA BETHANY Owner 575-317-7934 |
| Organization Subpart ? | No |
| Primary Taxonomy | 364SP0808X Clinical Nurse Specialist, Psych/Mental Health (Licence: NM CNP02864) |
| Enumeration Date | 2016-10-24 |
| Last Update Date | 2022-07-05 |