| NPI | 1134674385 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY-JANE QUICK Billing/Credentialing Manager 518-384-1517 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 082388-1) |
| Enumeration Date | 2016-08-17 |
| Last Update Date | 2016-08-17 |