| NPI | 1003528803 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA TURNER DOUGHERTY Sole Member, Licensed Psychologist 631-213-7690 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-12-23 |
| Last Update Date | 2022-12-23 |