| NPI | 1770612384 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVELYN BETTY BOTKIN President 631-549-3255 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 4634) |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2020-08-22 |