| NPI | 1194007930 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA BALTAZAR TATROE Owner/Provider 203-258-1876 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CT 005672) |
| Enumeration Date | 2011-09-19 |
| Last Update Date | 2011-09-19 |