| NPI | 1972367290 |
|---|---|
| Doing Business As | TELEMENTAL HEALTH LINK -NM |
| Doing Business As | TELEMENTAL HEALTH LINK NEW MEXICO |
| Doing Business As | THL NEW MEXICO |
| Entity Type | Organization |
| Authorized Contact | SUSAN M DERIVAS AO 208-775-7418 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2024-02-07 |
| Last Update Date | 2024-02-07 |