| NPI | 1417030651 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE A MCNALLY Office Manager 860-354-1596 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CT 002524) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103T00000X Psychologist | |
| 103TC0700X Psychologist, Clinical (Licence: CT 000964) | |
| 103TC0700X Psychologist, Clinical (Licence: CT 001600) | |
| 103TC0700X Psychologist, Clinical | |
| 1041C0700X Social Worker, Clinical (Licence: CT 002699) | |
| 1041C0700X Social Worker, Clinical | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2020-03-20 |