| NPI | 1578827754 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JILL GAVIN GANNON Founder 716-548-6190 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: NY 268088) |
| Additional Taxonomies | 174H00000X Health Educator (Licence: NY 268088) |
| Enumeration Date | 2012-07-02 |
| Last Update Date | 2012-07-02 |