| NPI | 1043335920 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA GRELLA HILLEBRAND Marriage And Family Therapist 516-617-2635 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 074243-1) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NY 6464) |
| 106H00000X Marriage & Family Therapist (Licence: NY 00155-1) | |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2008-06-05 |