| NPI | 1104190404 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY M RADOCCHIA Manager 860-644-0300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CT 004939) |
| Enumeration Date | 2012-03-05 |
| Last Update Date | 2012-03-05 |