| NPI | 1104298298 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL VALALIK Psychiatric Nurse Practitioner 203-640-1563 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 6276) |
| Enumeration Date | 2015-10-28 |
| Last Update Date | 2021-08-26 |