| NPI | 1891067377 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSA NELLY LAVERGNE Owner 917-445-6323 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: NY 000351-1) |
| Additional Taxonomies | 103TR0400X Psychologist, Rehabilitation (Licence: NJ 37RT00288300) |
| Enumeration Date | 2012-01-31 |
| Last Update Date | 2012-01-31 |