| NPI | 1457554644 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIK ANDREW MAYVILLE Clinical Psychologist 203-876-5917 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CT 002762) |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2020-08-22 |