| NPI | 1477158046 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IVY SARA PATT Licensed Clinical Psychologist 860-810-0587 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 103TC0700X Psychologist, Clinical | |
| 1041C0700X Social Worker, Clinical | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2020-12-02 |
| Last Update Date | 2022-02-18 |