| NPI | 1174056162 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBIN JILTON Secretary 914-242-2060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NY 013562) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: NY 015191) |
| Enumeration Date | 2017-04-06 |
| Last Update Date | 2017-04-06 |