| NPI | 1760513774 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL THERESA WAGNER Director Of Counseling 718-863-9134 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2020-08-22 |