| NPI | 1578100673 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATONYA SHERIEE KING Owner/Nurse Practitioner 860-471-3610 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2019-12-08 |
| Last Update Date | 2019-12-08 |