| NPI | 1962982173 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARISSA MOORE Licensed Mental Health Counselor 917-376-3564 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2018-08-16 |
| Last Update Date | 2022-01-11 |