| NPI | 1780400408 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AUDREY EVE LONGSON Owner 201-970-4353 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 101YP2500X Counselor Professional | |
| 103T00000X Psychologist | |
| 163W00000X Registered Nurse | |
| 207Q00000X Family Medicine | |
| 207R00000X Internal Medicine | |
| 208000000X Pediatrics | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2024-11-26 |
| Last Update Date | 2024-11-26 |