| NPI | 1215717962 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANA WALLACE Owner 203-441-7557 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 104100000X Social Worker |
| 1041C0700X Social Worker, Clinical | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2023-10-02 |
| Last Update Date | 2024-01-05 |