| NPI | 1235990508 |
|---|---|
| Doing Business As | SAGE MIND THERAPY |
| Entity Type | Organization |
| Authorized Contact | BIANCA BOUCHER Sole Member 315-767-0865 |
| Organization Subpart ? | No |
| Primary Taxonomy | 104100000X Social Worker |
| Enumeration Date | 2024-01-23 |
| Last Update Date | 2024-06-18 |