| NPI | 1124772637 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA C SHORT Licensed Clinical Social Worker 607-776-4151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-02-04 |
| Last Update Date | 2022-02-04 |