| NPI | 1538844519 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAVON M DOSTER Owner 347-322-3524 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TM1800X Psychologist, Intellectual & Developmental Disabilities |
| Enumeration Date | 2023-06-19 |
| Last Update Date | 2023-06-19 |