| NPI | 1407134554 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORA A KUSTRON Manager 860-683-2352 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CT 002140) |
| Enumeration Date | 2011-07-22 |
| Last Update Date | 2011-07-22 |