Organization
FAMILY TIME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BRENDA K. BAKER LMSW (CLINICAL COUNSELOR)
(505) 486-9942
Entity
Organization
Contact information
Practice address
19 ROAD 3953, FARMINGTON, NM 87401-7990
(505) 486-9942
Mailing address
19 ROAD 3953, FARMINGTON, NM 87401-7990
(505) 486-9942
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
M-06619
NM
Other
Enumeration date
11/09/2007
Last updated
11/09/2007
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