| NPI | 1568460988 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CANDICE P. UNGER Manager 716-833-6084 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 006789-1) |
| Enumeration Date | 2005-07-09 |
| Last Update Date | 2020-08-22 |