| NPI | 1164158085 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN COLWELL Director 203-232-7956 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 103G00000X Clinical Neuropsychologist | |
| Enumeration Date | 2022-07-25 |
| Last Update Date | 2023-08-08 |