| NPI | 1134311160 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE TOBIN Lpc 860-485-4245 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CT 001509) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CT 001509) |
| Enumeration Date | 2007-08-14 |
| Last Update Date | 2011-08-29 |