| NPI | 1033807524 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINA M TETI Social Worker 860-549-6449 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 104100000X Social Worker |
| Enumeration Date | 2023-04-24 |
| Last Update Date | 2023-04-24 |