| NPI | 1659063006 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOLLY L GRIMES Owner 347-806-1348 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 104100000X Social Worker |
| Enumeration Date | 2023-05-24 |
| Last Update Date | 2023-05-24 |