| NPI | 1558716647 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILFORD HYATT Director/Provider 646-621-0331 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 175F00000X Naturopath |
| Enumeration Date | 2016-04-26 |
| Last Update Date | 2016-04-26 |