| NPI | 1104302033 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE NWIGWE Ap RN, Owner 860-424-6042 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 4747) |
| Enumeration Date | 2018-07-13 |
| Last Update Date | 2019-07-04 |