| NPI | 1619563236 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ORQUIDEA BURGOS-JIMENEZ Mental Health Counselor 860-989-6726 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2020-12-17 |
| Last Update Date | 2020-12-17 |