| NPI | 1356695654 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE SHELTON Clinical Psychologist 203-998-1900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CT 3231) |
| Enumeration Date | 2012-11-08 |
| Last Update Date | 2012-11-08 |