| NPI | 1063644391 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTOR TIRADO-MONTANEZ Owner 860-372-4731 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CT 042939) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2009-08-20 |
| Last Update Date | 2012-07-19 |