| NPI | 1295249878 |
|---|---|
| Doing Business As | N/A |
| Entity Type | Organization |
| Authorized Contact | GIA LEO Owner 862-268-3101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NJ 44SC05542900) |
| Enumeration Date | 2017-11-19 |
| Last Update Date | 2020-08-14 |