| NPI | 1558647693 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANE KOU Owner 315-421-7479 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY 163572) |
| Enumeration Date | 2011-11-02 |
| Last Update Date | 2011-11-02 |