| NPI | 1093176356 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACEY ANNE ROBINSON Manager 860-305-8518 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: CT 002003) |
| Enumeration Date | 2016-03-15 |
| Last Update Date | 2016-03-15 |