| NPI | 1275935652 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE FITZGERALD-LOCKWOOD Clinical Social Worker 860-894-2384 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2014-09-17 |
| Last Update Date | 2014-09-17 |