| NPI | 1356018790 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERNESTO NOAM LIRA DE LA ROSA Licensed Clinical Psychologist 347-652-1148 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling |
| Enumeration Date | 2021-08-24 |
| Last Update Date | 2021-08-24 |