| NPI | 1003978826 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE ELAINE SLOAN-SMITH Clinic Therapist 315-253-9795 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2020-08-22 |