| NPI | 1013741495 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SASHA GRAHAM GIVANS Nurse Practitioner 860-869-9192 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-08-28 |
| Last Update Date | 2025-07-24 |