| NPI | 1477042562 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN BHOGAL Director 917-554-3669 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PA PA017028) |
| Enumeration Date | 2018-05-04 |
| Last Update Date | 2018-05-04 |