| NPI | 1104127984 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TATYANA SEMENOVA Phisician 347-277-9084 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: NY 2592091) |
| Enumeration Date | 2010-11-09 |
| Last Update Date | 2010-11-09 |