| NPI | 1114469657 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HANNAH D JACKSON Professional Counselor 860-888-7040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CT 3048) |
| Enumeration Date | 2016-11-15 |
| Last Update Date | 2016-11-15 |