| NPI | 1154690857 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARYAM KHWAJA Therapist 917-517-5128 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 077923) |
| Enumeration Date | 2011-12-26 |
| Last Update Date | 2011-12-26 |