| NPI | 1508580937 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE SHALL-MCCUMISKEY Owner 646-479-8068 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral |
| Enumeration Date | 2022-09-29 |
| Last Update Date | 2022-09-29 |