NPI | 1780078386 |
---|---|
Entity Type | Organization |
Authorized Contact | CHRISTOPHER JOSEPH KELLER Owner/Provider 716-450-3934 |
Organization Subpart ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 019744) |
Enumeration Date | 2015-03-23 |
Last Update Date | 2018-11-25 |