| NPI | 1639719545 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VALERIE MARTIN Licensed Clinical Social Worker 860-948-8178 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2020-01-08 |
| Last Update Date | 2020-01-08 |