| NPI | 1669075818 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW HOLDER Owner 917-608-5519 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 261QD1600X Clinic/Center, Developmental Disabilities | |
| Enumeration Date | 2020-11-19 |
| Last Update Date | 2021-04-14 |