| NPI | 1962741553 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTEN RENSHAW Co Director 646-481-0184 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 078168) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NY 079144) |
| Enumeration Date | 2013-02-03 |
| Last Update Date | 2013-02-03 |