| NPI | 1205052321 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GWENETTE BERYL GIBSON Certified Occu PT Ional Theapy Asst 917-797-3793 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2023-09-06 |