| NPI | 1063928372 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA MOROZOV Director 347-770-7631 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 020920-1) |
| Enumeration Date | 2017-12-21 |
| Last Update Date | 2017-12-21 |