NPI | 1649008962 |
---|---|
Entity Type | Organization |
Authorized Contact | MELISSA KING Director Of Credential & Enrollment 860-322-6712 |
Organization Subpart ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
101YM0800X Counselor, Mental Health | |
1041C0700X Social Worker, Clinical | |
207R00000X Internal Medicine | |
2083A0300X Preventive Medicine, Addiction Medicine | |
363LF0000X Nurse Practitioner, Family | |
363LP0808X Nurse Practitioner, Psych/Mental Health | |
Enumeration Date | 2024-07-26 |
Last Update Date | 2024-07-26 |