| NPI | 1417516634 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DESTINY GILLMAN Licensed Marriage And Family Therap 860-428-3400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2019-06-11 |
| Last Update Date | 2019-11-20 |