| NPI | 1891402673 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAKISHA FULMORE Licensed Mental Health Counselor 516-774-1341 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2022-11-01 |
| Last Update Date | 2022-11-16 |