| NPI | 1588170971 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLYN E WALDECKER Executive Director 516-551-3153 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NY 019641) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: NY 022047) |
| Enumeration Date | 2017-12-20 |
| Last Update Date | 2021-11-29 |