| NPI | 1649493115 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAFAEL MORA DE JESUS Director 860-296-0094 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CT 001877) |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2020-08-22 |