| NPI | 1396151379 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLEN T. LACKO Social Worker 203-733-5529 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: CT 003021) |
| Enumeration Date | 2014-07-10 |
| Last Update Date | 2014-07-10 |