| NPI | 1164054698 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS A CORDIER Executive Director Of Clinical Prog 860-430-5515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral |
| Enumeration Date | 2020-02-12 |
| Last Update Date | 2020-02-12 |