| NPI | 1619679305 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHRYN L. JEWELL Owner 315-456-8693 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2023-03-20 |
| Last Update Date | 2023-03-20 |