| NPI | 1518405059 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL T AMBLE Owner 203-245-1579 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TP0016X Psychologist, Prescribing (Medical) (Licence: CT 0032040) |
| Enumeration Date | 2017-02-04 |
| Last Update Date | 2017-02-06 |