| NPI | 1326442567 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER VIETZE Owner 347-668-4992 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 251S00000X | |
| Enumeration Date | 2014-10-17 |
| Last Update Date | 2020-06-08 |