| NPI | 1104065895 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANET SHAPIRO-WEISS Medical Director 860-344-9558 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: CT 24301) |
| Enumeration Date | 2009-02-19 |
| Last Update Date | 2009-02-19 |