| NPI | 1710522875 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY C LEATHERSICH Practice Administrator 585-673-2319 |
| Organization Subpart ? | No |
| Primary Taxonomy | 364SP0808X Clinical Nurse Specialist, Psych/Mental Health |
| Enumeration Date | 2019-11-13 |
| Last Update Date | 2019-11-13 |