| NPI | 1013522093 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUTH L JACOBSON Marriage & Family Therapist 860-604-3101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Enumeration Date | 2020-09-15 |
| Last Update Date | 2020-09-15 |