| NPI | 1962821314 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLA J MARTIN Director 505-720-4564 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NM 4501) |
| Enumeration Date | 2014-04-14 |
| Last Update Date | 2014-04-14 |