| NPI | 1114061157 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELDA STOREY CHESEBROUGH Owner 860-572-4969 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CT 005649) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CT 002410) |
| 1041C0700X Social Worker, Clinical (Licence: CT 007830) | |
| 106H00000X Marriage & Family Therapist (Licence: CT 001256) | |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2018-06-21 |