| NPI | 1962949941 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBIN BLACKWELL Clinical Social Worker 505-440-9303 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NM C-05040) |
| Enumeration Date | 2017-01-27 |
| Last Update Date | 2017-01-27 |