| NPI | 1467074591 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE MARIE HARBRIDGE Nys Licensed Psychologist 716-946-4804 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2020-05-12 |
| Last Update Date | 2022-09-11 |