| NPI | 1508263880 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA A MITCHELL Owner 860-470-3915 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CT 003084) |
| Enumeration Date | 2014-12-02 |
| Last Update Date | 2014-12-02 |