| NPI | 1356567341 |
|---|---|
| Other Name | LLC |
| Entity Type | Organization |
| Authorized Contact | SUSAN E PETERMAN Owner 860-233-8111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CT 1631) |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2019-12-18 |