| NPI | 1427497882 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEAN RICHARD LADOUCEUR Owner 860-593-8373 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Additional Taxonomies | 101YP2500X Counselor Professional |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2013-06-19 |
| Last Update Date | 2013-11-13 |