| NPI | 1700640489 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY LOUISE LARA GABRIEL Mental Health Counselor 917-604-5592 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2024-02-12 |
| Last Update Date | 2024-02-12 |