| NPI | 1114484987 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANYA LEE CLARK Incorporator 860-497-0239 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant |
| 225100000X Physical Therapist | |
| 225200000X Physical Therapy Assistant | |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2019-02-27 |
| Last Update Date | 2020-04-16 |