| NPI | 1063846277 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA R CAMPBELL Executive Director 860-567-7724 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CT 000840) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CT 000840) |
| Enumeration Date | 2013-08-23 |
| Last Update Date | 2015-03-02 |