| NPI | 1144876392 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRACE CULLEN Medical Billing Manager 203-368-5515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| Enumeration Date | 2019-08-14 |
| Last Update Date | 2020-09-22 |