| NPI | 1174069686 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAUNTE MARIA LEVASSEUR Licensed Clinical Social Worker 203-752-7135 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: ME LC15394) |
| Enumeration Date | 2017-01-09 |
| Last Update Date | 2017-01-09 |