| NPI | 1538454962 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUBA NAKHUTINA Owner/President 917-470-1336 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist |
| Additional Taxonomies | 103T00000X Psychologist |
| 103TB0200X Psychologist, Cognitive & Behavioral | |
| 103TF0200X Psychologist, Forensic | |
| 103TH0004X Psychologist, Health | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities | |
| 103TR0400X Psychologist, Rehabilitation | |
| Enumeration Date | 2011-06-14 |
| Last Update Date | 2012-01-12 |