| NPI | 1710758420 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUIS ANTONIO LOPEZ Ower/Mental Health Practitioner 917-545-2674 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2024-01-11 |
| Last Update Date | 2024-01-11 |