| NPI | 1053737965 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERYL LACOURSIERE Owner 203-264-8000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: CT 3861) |
| Additional Taxonomies | 103TP0016X Psychologist Prescribing (Medical) |
| 363LF0000X Nurse Practitioner Family (Licence: CT 3861) | |
| Enumeration Date | 2014-03-16 |
| Last Update Date | 2020-09-25 |