| NPI | 1982081667 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA GIFFORD Billing Manager 315-732-9368 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 0784091) |
| Enumeration Date | 2015-05-01 |
| Last Update Date | 2015-05-01 |