| NPI | 1225354988 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID EWING Owner 203-433-0299 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: CT 006202) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: CT 005763) |
| Enumeration Date | 2010-04-20 |
| Last Update Date | 2014-10-29 |