| NPI | 1639525579 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA HETHERINGTON Owner 860-917-5054 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CT 006610) |
| Enumeration Date | 2016-05-10 |
| Last Update Date | 2016-05-10 |