NPI | 1285123711 |
---|---|
Entity Type | Organization |
Authorized Contact | RONALD L CLARK Licensed Clinical Social Worker 315-326-0155 |
Organization Subpart ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY R053849) |
Enumeration Date | 2018-05-10 |
Last Update Date | 2018-05-10 |