| NPI | 1851636104 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINE A MARRA Sole Member 518-587-0499 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 014506-1) |
| Enumeration Date | 2012-11-27 |
| Last Update Date | 2015-08-13 |