| NPI | 1679086920 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANINE COLASUONNO Owner 631-379-2456 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NY 000585-1) |
| Enumeration Date | 2017-11-08 |
| Last Update Date | 2019-05-13 |