| NPI | 1376138826 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAYLYN BANNING Owner 860-449-3817 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2021-03-06 |
| Last Update Date | 2021-03-06 |