| NPI | 1306159405 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARRELL D. LACOCK President 203-245-8732 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CT 000940) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CT 001164) |
| Enumeration Date | 2010-07-17 |
| Last Update Date | 2010-07-17 |