| NPI | 1376252924 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALFONSO LLEWELLYN FERGUSON Executive Director 646-971-0512 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YP2500X Counselor Professional | |
| 103TC1900X Psychologist Counseling | |
| Enumeration Date | 2022-11-22 |
| Last Update Date | 2022-11-22 |