| NPI | 1619248762 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY MICHAEL BROWN Clinical Director 315-221-4381 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 061925) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2012-01-21 |
| Last Update Date | 2012-01-21 |