| NPI | 1063294866 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIJIN KIM Owner 917-767-5237 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2023-10-17 |
| Last Update Date | 2023-10-17 |