| NPI | 1538342829 |
|---|---|
| Doing Business As | CONNECTICUT CENTER FOR HUMAN GROWTH& DEV. |
| Entity Type | Organization |
| Authorized Contact | WALTER JOHANNES VAN SAMBECK Owner 860-537-3977 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CT 000493) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CT 000493) |
| 103TP0016X Psychologist, Prescribing (Medical) (Licence: CT 023879) | |
| Enumeration Date | 2007-12-10 |
| Last Update Date | 2008-06-16 |