| NPI | 1063962900 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESE BALLET Licensed Clinical Social Worker 860-778-3304 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CT 008738) |
| Enumeration Date | 2016-10-04 |
| Last Update Date | 2016-10-04 |