| NPI | 1124829643 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE COOGAN Director/Clinical Social Worker 631-513-1059 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2025-03-20 |
| Last Update Date | 2025-04-21 |