| NPI | 1457895419 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY NICOLE BOLELLA Manager 860-205-9434 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CT 8261) |
| Enumeration Date | 2016-12-10 |
| Last Update Date | 2016-12-10 |