| NPI | 1164652871 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DUANE KELLOGG Director 203-255-5078 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 101YP2500X Counselor Professional |
| 106H00000X Marriage & Family Therapist | |
| 103TC0700X Psychologist Clinical | |
| 1041C0700X Social Worker Clinical | |
| Enumeration Date | 2009-07-16 |
| Last Update Date | 2015-02-19 |