| NPI | 1013395466 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DILICE ROBERTSON Member 203-887-1278 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 003973) |
| Enumeration Date | 2015-05-18 |
| Last Update Date | 2015-05-18 |