| NPI | 1578137360 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON BOIVIN Licensed Clinical Social Worker 860-327-5850 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2021-05-17 |
| Last Update Date | 2021-05-17 |