| NPI | 1659651321 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AILEEN MARTIN Executive Director 315-782-9450 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 080061-1) |
| Enumeration Date | 2011-08-25 |
| Last Update Date | 2011-08-25 |