| NPI | 1457880122 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SYMA SHAFFER Credentialing 631-466-7053 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 060983-1) |
| Enumeration Date | 2017-06-07 |
| Last Update Date | 2022-07-21 |