| NPI | 1043954530 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCY S PUKLIN Licensed Clinical Social Worker 203-858-5560 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical |
| Enumeration Date | 2022-04-21 |
| Last Update Date | 2022-04-21 |