NPI | 1386782977 |
---|---|
Entity Type | Organization |
Authorized Contact | PETER D RADASCH Vice President 860-236-7333 |
Organization Subpart ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CT 002295) |
Additional Taxonomies | 103TF0200X Psychologist, Forensic (Licence: CT 002394) |
1041C0700X Social Worker, Clinical (Licence: CT 006385) | |
Enumeration Date | 2007-02-03 |
Last Update Date | 2019-02-06 |