| NPI | 1629108519 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW STEPHEN LABARGE Member 518-439-1641 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: NY 014976) |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2020-08-22 |