| NPI | 1952943904 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN LORETTA LEE Owner 575-800-5902 |
| Organization Subpart ? | No |
| Primary Taxonomy | 364SP0808X Clinical Nurse Specialist, Psych/Mental Health |
| Enumeration Date | 2019-10-10 |
| Last Update Date | 2019-10-10 |