| NPI | 1629316492 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER CHARBONNIER Marital & Family Therapist 860-388-3520 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CT 000386) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: CT 000386) |
| Enumeration Date | 2013-01-29 |
| Last Update Date | 2013-01-29 |