| NPI | 1649046285 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GABRIELLE KEENE Owner 860-218-0942 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 103T00000X Psychologist |
| 103TC0700X Psychologist Clinical | |
| 103TC1900X Psychologist Counseling | |
| 103TC2200X Psychologist Clinical Child & Adolescent | |
| 1041C0700X Social Worker Clinical | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2023-11-27 |
| Last Update Date | 2023-12-18 |