| NPI | 1205223278 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD FERNANDEZ Owner 917-686-8020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: NY 019609) |
| Enumeration Date | 2015-04-17 |
| Last Update Date | 2015-04-17 |