| NPI | 1235183849 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA E STEPHENS Business Owner 315-735-0804 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 205576) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F400236) |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2020-08-22 |