| NPI | 1043056047 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREN PETRO Owner 585-955-3655 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2024-07-08 |
| Last Update Date | 2024-07-08 |