| NPI | 1326649146 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HATSHEPSUT NOLENE KISA-DAVIDSON Chief Clinician 347-465-0684 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Enumeration Date | 2020-11-06 |
| Last Update Date | 2020-11-06 |