| NPI | 1336679703 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRISTA ALBERT Clinician 860-371-7715 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CT 002952) |
| Enumeration Date | 2017-06-18 |
| Last Update Date | 2017-06-18 |