| NPI | 1023411816 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN J GREEN Psychotherapist 845-707-2542 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 0714321) |
| Enumeration Date | 2014-10-07 |
| Last Update Date | 2014-10-07 |