| NPI | 1316454705 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANICE L SHIELDS Licensed Clinical Social Worker 860-967-1175 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: CT 009575) |
| Enumeration Date | 2018-01-07 |
| Last Update Date | 2018-01-07 |