| NPI | 1578052114 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARA SIENA NGUYEN Member 860-307-0379 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TP2701X Psychologist, Group Psychotherapy (Licence: CT 002940) |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2018-05-09 |
| Last Update Date | 2018-05-10 |