| NPI | 1790922433 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NELLY L STA MARIA Clinical Psychologist 646-895-0794 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NY 017642) |
| Enumeration Date | 2009-01-16 |
| Last Update Date | 2009-01-16 |