| NPI | 1184007841 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARQUIA DAVIS Owner 860-722-4458 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CT 008511) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CT 008511) |
| Enumeration Date | 2015-06-30 |
| Last Update Date | 2015-07-07 |