| NPI | 1467998674 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LILLIAN LASHAE OUTLAW Owner 203-317-3333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CT 008874) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YP2500X Counselor, Professional | |
| 1041C0700X Social Worker, Clinical | |
| 251S00000X (Licence: CT 008874) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2017-01-11 |
| Last Update Date | 2023-11-28 |