| NPI | 1467982504 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIO RENE DURAN Owner 860-966-1004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 7027) |
| Enumeration Date | 2017-06-12 |
| Last Update Date | 2022-07-21 |