| NPI | 1114082310 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH PAUL WAGENSELLER President 203-226-6725 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 103TP2701X Psychologist, Group Psychotherapy (Licence: CT C-0116) |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2013-11-14 |