| NPI | 1972303170 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANYA C. WAYNE Marriage And Family Therapist 607-857-0143 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2025-03-17 |
| Last Update Date | 2025-03-17 |