| NPI | 1245470103 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID D. ILSON Psychotherapist 516-594-0331 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NY PR 033101-1) |
| Enumeration Date | 2009-03-04 |
| Last Update Date | 2009-03-04 |