| NPI | 1699332288 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIRON SHAMALOV Behavioral Therapist 347-476-4339 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Enumeration Date | 2019-05-20 |
| Last Update Date | 2019-05-20 |