| NPI | 1114214673 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA GLORIA WADE-RANCOURT President 860-740-2228 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical |
| Additional Taxonomies | 101YP2500X Counselor Professional |
| 1041C0700X Social Worker Clinical (Licence: CT 005773) | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2011-07-06 |
| Last Update Date | 2021-12-13 |