| NPI | 1205682424 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAHIL CHOUDHRY Assistant Secretary 862-576-2389 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 103T00000X Psychologist |
| 104100000X Social Worker | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2024-04-29 |
| Last Update Date | 2024-04-29 |