| NPI | 1326132242 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAY JUODAITIS Office Manager 203-454-1171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 101Y00000X Counselor (Licence: CT 002510) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2014-05-07 |