| NPI | 1932505138 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE LYNN FLEMING Clinical Therapist 917-364-3785 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: NJ 37PC00510200) |
| Additional Taxonomies | 251S00000X (Licence: NJ 37PC00510200) |
| 252Y00000X Early Intervention Provider Agency (Licence: FL MH11779) | |
| 251S00000X (Licence: FL MH 11779) | |
| Enumeration Date | 2014-11-15 |
| Last Update Date | 2014-11-15 |