| NPI | 1134513062 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACEY HANSEN Owner 860-214-4695 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CT 001227) |
| Enumeration Date | 2015-03-28 |
| Last Update Date | 2015-07-01 |