| NPI | 1013421080 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMANUEL R PETRACCA General Partner 585-586-6840 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| 103TC1900X Psychologist, Counseling | |
| Enumeration Date | 2017-11-28 |
| Last Update Date | 2017-11-28 |