NPI | 1487059523 |
---|---|
Entity Type | Organization |
Authorized Contact | RYAN M KULL Director 917-991-8417 |
Organization Subpart ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY PR061627-1) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2014-10-31 |
Last Update Date | 2018-03-17 |