| NPI | 1669122388 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRETT NELSON Owner 518-855-1984 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2022-03-25 |
| Last Update Date | 2022-03-25 |