| NPI | 1508409731 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVENDER PANWAR Owner 203-404-1010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 103TA0400X Psychologist Addiction (Substance Use Disorder) |
| 103TC0700X Psychologist Clinical | |
| 103TC1900X Psychologist Counseling | |
| 103TP0016X Psychologist Prescribing (Medical) | |
| Enumeration Date | 2019-10-21 |
| Last Update Date | 2019-10-21 |