| NPI | 1063048452 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONNIE JOHNSON Lpc 203-313-3873 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2020-03-17 |
| Last Update Date | 2020-03-17 |