| NPI | 1043435597 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLINE RAE RUSSELL SMITH Co Owner 518-857-9361 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NY 014405-1) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: NY 070617-1) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2020-08-22 |