| NPI | 1164910477 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLAS FAGER Owner 203-253-6602 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NY 008364) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY 008313) |
| 1041C0700X Social Worker, Clinical (Licence: NY 085005-1) | |
| Enumeration Date | 2018-04-23 |
| Last Update Date | 2018-04-23 |