NPI | 1396451043 |
---|---|
Entity Type | Organization |
Authorized Contact | RUBY MENSAH Pmhnp 860-823-9886 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
Enumeration Date | 2023-01-26 |
Last Update Date | 2023-01-26 |