NPI | 1629158126 |
---|---|
Entity Type | Organization |
Authorized Contact | BASSAM AWWA Medical Director 860-437-6914 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
363LP0808X Nurse Practitioner, Psych/Mental Health | |
103TC0700X Psychologist, Clinical | |
1041C0700X Social Worker, Clinical | |
106H00000X Marriage & Family Therapist | |
101YP2500X Counselor, Professional | |
Enumeration Date | 2006-10-17 |
Last Update Date | 2015-11-16 |