| NPI | 1881164085 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA HENDRICKSON DAVID HENDRICKSON Owner 631-838-7183 |
| Organization Subpart ? | |
| Primary Taxonomy | 1041C0700X Social Worker Clinical |
| Additional Taxonomies | 104100000X Social Worker |
| 225700000X Massage Therapist | |
| Enumeration Date | 2018-11-29 |
| Last Update Date | 2018-11-29 |