| NPI | 1134656564 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DINELLY HOLDER Director 516-268-0064 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NY 005132) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NJ 37PC00459100) |
| Enumeration Date | 2017-05-16 |
| Last Update Date | 2017-05-16 |