| NPI | 1114464526 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY CHRISTINE PERL Owner 917-515-7884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701005883) |
| Enumeration Date | 2017-01-23 |
| Last Update Date | 2017-01-23 |