| NPI | 1043841794 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHYAMLI SHAH Licensed Professional Counselor 862-222-3371 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2020-01-31 |
| Last Update Date | 2020-01-31 |