| NPI | 1417358235 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICIA M SISK Psychotherapist 646-924-9384 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NY 047527) |
| Enumeration Date | 2014-09-11 |
| Last Update Date | 2014-09-11 |