| NPI | 1245400555 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLADYS QUINNONES Owner 860-462-3966 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| 2084P0805X | |
| 208D00000X General Practice | |
| 103T00000X Psychologist | |
| Enumeration Date | 2008-03-04 |
| Last Update Date | 2008-03-16 |