| NPI | 1063867679 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA GIBSON Licensed Clinical Social Worker 203-815-5061 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CT 7950) |
| Enumeration Date | 2016-05-02 |
| Last Update Date | 2016-05-02 |