| NPI | 1184480543 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JODIANNE FITZGERALD Licensed Mental Health Counselor 631-621-8152 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2024-02-23 |
| Last Update Date | 2024-02-23 |