NPI | 1336256213 |
---|---|
Other Name | CHILD & FAM SVC OTPT MH CL |
Entity Type | Organization |
Authorized Contact | JEANNE MADDOX Billing Manager 315-671-2959 |
Organization Subpart ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2006-08-24 |
Last Update Date | 2008-06-25 |