| NPI | 1538615141 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE BLOOM Owner Provider 888-517-4992 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 081585) |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2016-09-01 |