| NPI | 1881071819 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMARIE A SHEPPARD Executive Director 518-374-7873 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 103TC0700X) |
| Enumeration Date | 2015-04-28 |
| Last Update Date | 2015-04-28 |