| NPI | 1861897803 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE PAN Licensed Mental Health Counselor 631-637-0579 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NY 005554) |
| Enumeration Date | 2014-11-04 |
| Last Update Date | 2015-05-25 |