| NPI | 1093117632 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE WALDSCHMIDT Mental Health Counselor 315-246-3227 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2014-09-25 |
| Last Update Date | 2014-09-25 |