| NPI | 1093242091 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSE DANIEL CHASMAN Director 860-997-4723 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: SC 1449) |
| Enumeration Date | 2017-05-22 |
| Last Update Date | 2017-05-22 |