| NPI | 1558837567 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL COOK Owner 347-991-4946 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling |
| Enumeration Date | 2018-10-17 |
| Last Update Date | 2019-07-30 |