| NPI | 1184404543 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA MULLEN Director 929-276-2181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2023-10-03 |
| Last Update Date | 2023-10-03 |