| NPI | 1295578565 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AISHWARYA MANJUNATH SASTRY Director 631-891-5977 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 101YP2500X Counselor Professional |
| Enumeration Date | 2024-06-14 |
| Last Update Date | 2024-06-21 |