| NPI | 1063871432 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARMAINE FANARA Counselor 716-783-0407 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NY 004189) |
| Enumeration Date | 2016-02-15 |
| Last Update Date | 2016-02-15 |