| NPI | 1649702960 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY D TEAMER Owner 845-240-4941 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 079690) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY 0044971) |
| 1041C0700X Social Worker, Clinical (Licence: NY 0781631) | |
| Enumeration Date | 2017-03-28 |
| Last Update Date | 2017-03-28 |