| NPI | 1710578604 |
|---|---|
| Doing Business As | GRACE JOHNSON |
| Entity Type | Organization |
| Authorized Contact | GRACE JOHNSON Owner 631-942-0031 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2021-02-02 |
| Last Update Date | 2021-02-02 |