| NPI | 1588460463 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL FLACK Sole Member 203-208-8641 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical |
| Additional Taxonomies | 103TF0200X Psychologist Forensic |
| Enumeration Date | 2025-02-21 |
| Last Update Date | 2025-02-24 |