| NPI | 1962765016 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT MYERS Executive Director 315-798-4040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry |
| Enumeration Date | 2012-06-22 |
| Last Update Date | 2012-11-12 |