| NPI | 1164200614 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOLLY J MCCORMICK Licensed Clinical Social Worker 607-398-0631 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2023-09-18 |
| Last Update Date | 2025-11-19 |