| NPI | 1356834618 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NADINE TENNEISE WILLIAMS Member 860-878-1116 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CT 008424) |
| Enumeration Date | 2018-06-12 |
| Last Update Date | 2018-06-12 |