| NPI | 1649794629 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH DOUGLAS BLACKBURN Clinical Supervisor 212-865-0960 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: NY 085451) |
| Enumeration Date | 2017-08-01 |
| Last Update Date | 2017-08-01 |