| NPI | 1427672054 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA QUICK Therapist/Mental Health Provider 315-725-8687 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2020-05-29 |
| Last Update Date | 2020-05-29 |