| NPI | 1003802190 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA MITCHELL Director 585-396-4363 |
| Organization Subpart ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: NY 6879100A) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NY 6879100A) |
| 103TC0700X Psychologist, Clinical (Licence: NY 6879100A) | |
| 1041C0700X Social Worker, Clinical (Licence: NY 6879100A) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 6879100A) | |
| 363L00000X Nurse Practitioner (Licence: NY 6879100A) | |
| Enumeration Date | 2005-09-23 |
| Last Update Date | 2021-04-01 |