| NPI | 1457845059 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JILL R CIRCELLI Clinical Social Worker 315-725-0461 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY R080087-1) |
| Enumeration Date | 2018-06-18 |
| Last Update Date | 2019-11-13 |