| NPI | 1235944976 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STAS SOKOLIN CFO 347-407-0343 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2025-02-10 |
| Last Update Date | 2025-04-02 |