| NPI | 1629774369 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EILEEN A FISHER Owner/ Practitioner 315-657-2460 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2023-02-03 |
| Last Update Date | 2023-06-07 |