| NPI | 1306693593 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE KLUCZINSKE Owner, President 315-413-9877 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2024-05-04 |
| Last Update Date | 2024-05-04 |