| NPI | 1134411614 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THEANVY KUOCH Executive Director 860-561-3345 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CT 014898) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CT 000638) |
| 364SP0809X Clinical Nurse Specialist, Psych/Mental Health, Adult (Licence: CT 003364) | |
| Enumeration Date | 2011-05-03 |
| Last Update Date | 2016-10-24 |