| NPI | 1134639065 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YVETTE BUNTING- WATTS Owner/Manager 203-927-2554 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CT 003192) |
| 104100000X Social Worker | |
| 106H00000X Marriage & Family Therapist | |
| 225X00000X Occupational Therapist | |
| 363LP0200X Nurse Practitioner, Pediatrics | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2017-10-05 |
| Last Update Date | 2023-01-10 |