| NPI | 1548530959 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ISABELLA DAVYDOVA Licensed Mental Health Counselor 718-374-6765 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NY 0043091) |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: NY 004309-1) |
| 251S00000X (Licence: NY 0043091) | |
| Enumeration Date | 2012-01-03 |
| Last Update Date | 2016-12-19 |