| NPI | 1982666822 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAFER ZYZMAN CEO 631-647-7885 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 011241) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 025669) |
| 225X00000X Occupational Therapist (Licence: NY 009040) | |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2019-06-22 |