| NPI | 1942714308 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARA J BRANDON Licensed Clinical Social Worker 646-632-5377 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: NY 085699) |
| Enumeration Date | 2017-11-21 |
| Last Update Date | 2017-11-21 |