| NPI | 1003348368 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY K GOUDREAULT Sole Proprietor 860-416-3072 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CT 9729) |
| Enumeration Date | 2017-03-28 |
| Last Update Date | 2017-03-28 |