| NPI | 1235746934 |
|---|---|
| Other Name | NOT APPLICABLE |
| Entity Type | Organization |
| Authorized Contact | ALEXANDRA R NELSON Psychologist 860-550-3639 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Enumeration Date | 2020-09-26 |
| Last Update Date | 2020-09-26 |