| NPI | 1093080129 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD J FEDERICI Owner/Operator 860-402-0394 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 251S00000X (Licence: CT 000684) |
| 101Y00000X Counselor | |
| 101YM0800X Counselor, Mental Health | |
| 101YP2500X Counselor, Professional | |
| 103T00000X Psychologist | |
| 103TB0200X Psychologist, Cognitive & Behavioral | |
| 103TC1900X Psychologist, Counseling | |
| 103TF0000X Psychologist, Family | |
| 103TP2701X Psychologist, Group Psychotherapy | |
| 104100000X Social Worker | |
| Enumeration Date | 2012-03-22 |
| Last Update Date | 2016-06-27 |