| NPI | 1649035684 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TASIA A HENDERSON Behavioral Healthcare Provider 917-994-0557 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2024-02-19 |
| Last Update Date | 2024-07-03 |