| NPI | 1215329743 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA ANN TULLY Therapist 347-907-3646 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 73074208-R) |
| Enumeration Date | 2015-02-20 |
| Last Update Date | 2015-02-20 |