| NPI | 1487434163 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERICA M PONTEEN, PHD, LCSW Clinical Social Worker 929-563-8800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 171000000X Military Health Care Provider |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 1744R1102X Specialist, Research Study | |
| Enumeration Date | 2023-10-02 |
| Last Update Date | 2023-10-02 |