| NPI | 1700424967 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW VERNON BUKOWSKI Owner/Employee 302-593-4598 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 251X00000X |
| Enumeration Date | 2019-12-18 |
| Last Update Date | 2021-03-04 |