| NPI | 1043583131 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICE MIRIAM WOODSON WHITE Sole Proprietor/Mental Health Therapy 631-675-9494 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: NY 73 081011) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY 0720745441) |
| Enumeration Date | 2012-02-20 |
| Last Update Date | 2013-08-07 |