| NPI | 1063904902 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAVIER ARGUELLO Executive Director 203-675-4267 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TE1100X Psychologist Exercise & Sports |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral |
| 103TM1800X Psychologist Mental Retardation & Developmental Disabilities | |
| 103TR0400X Psychologist Rehabilitation | |
| Enumeration Date | 2018-06-06 |
| Last Update Date | 2018-06-06 |