| NPI | 1548322423 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOGAN GREEN Neuropsychologist 860-632-1296 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TF0200X Psychologist Forensic (Licence: CT 852) |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2020-08-22 |