| NPI | 1083052468 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL JOSEPH WEISS Director 203-540-5186 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CT 003214) |
| Additional Taxonomies | 101YS0200X Counselor, School (Licence: CT 003214) |
| 103K00000X Behavior Analyst (Licence: CT 003214) | |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: CT 003214) | |
| 103TC0700X Psychologist, Clinical (Licence: CT 003214) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CT 003214) | |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2013-06-07 |
| Last Update Date | 2015-11-17 |