| NPI | 1306246376 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT PEALE MOONEY Psychologist 315-342-5941 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 1041C0700X Social Worker, Clinical | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2014-08-27 |
| Last Update Date | 2014-08-27 |