| NPI | 1659931699 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER MAGONE Licensed Clinical Social Worker 631-877-6793 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2019-06-20 |
| Last Update Date | 2019-06-20 |