| NPI | 1558677518 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARA L SHIPMAN Therapist 315-472-4471 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NY P76297) |
| Enumeration Date | 2010-08-27 |
| Last Update Date | 2010-08-27 |