| NPI | 1114313822 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE BENJAMIN Clinical Supervisor 347-262-6434 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NY 074052-1) |
| Enumeration Date | 2015-04-09 |
| Last Update Date | 2015-04-09 |