| NPI | 1568892214 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY LORRAINE PETERSEN President 631-988-9812 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY R023294) |
| Enumeration Date | 2013-11-16 |
| Last Update Date | 2013-12-06 |