| NPI | 1275277782 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA MUSTILLO Licensed Clinical Social Worker 917-992-7896 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2022-04-21 |
| Last Update Date | 2022-08-09 |