| NPI | 1194158345 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIA CRESHAM Owner/Operator 860-618-3236 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CT 001379) |
| Enumeration Date | 2013-08-12 |
| Last Update Date | 2013-08-12 |