| NPI | 1437494804 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEGHAN JACKSON MILLER Owner 917-992-1569 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 019103) |
| Enumeration Date | 2012-12-11 |
| Last Update Date | 2015-05-12 |