| NPI | 1013241215 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALONZO FRITZGERALD WATTS Owner 203-410-4966 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CT 006845) |
| Enumeration Date | 2009-09-22 |
| Last Update Date | 2019-06-18 |