| NPI | 1497417208 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACEY DELIENNE Member 646-759-2641 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2021-10-08 |
| Last Update Date | 2024-02-06 |