| NPI | 1457699712 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVAN FOX Owner 860-430-1150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry |
| Enumeration Date | 2013-01-22 |
| Last Update Date | 2013-01-22 |