| NPI | 1407430499 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONIQUE EDWARDS Manager 860-977-7549 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor, Mental Health | |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2021-05-06 |
| Last Update Date | 2022-12-14 |