NPI | 1093089948 |
---|---|
Entity Type | Organization |
Authorized Contact | PHILLIP SYLVESTER Partner 860-347-8894 |
Organization Subpart ? | No |
Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: CT 004228) |
Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CT 000329) |
103TC1900X Psychologist Counseling | |
Enumeration Date | 2012-02-23 |
Last Update Date | 2012-02-23 |