| NPI | 1407653918 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARLENE SOTELO-DYNEGA Psychologist/Member Manager 347-610-1036 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2025-03-03 |
| Last Update Date | 2025-03-03 |