| NPI | 1275814147 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY M SULLIVAN Clinical Social Worker 203-962-2209 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CT 005814) |
| Enumeration Date | 2011-09-06 |
| Last Update Date | 2014-02-07 |