| NPI | 1619428422 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADEN JOEPHSON Owner/Psychologist 917-776-5433 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: RI PS01524) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: RI ISW01666) |
| 106E00000X Assistant Behavior Analyst (Licence: RI LBA00074) | |
| Enumeration Date | 2016-10-17 |
| Last Update Date | 2016-10-17 |