| NPI | 1770174070 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREY DAVYDOV Licensed Clinical Social Worker 917-463-6553 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2021-01-29 |
| Last Update Date | 2021-01-29 |