| NPI | 1760112262 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARY CHUGH Secretary 716-636-1375 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2022-06-16 |
| Last Update Date | 2022-06-16 |