| NPI | 1649596214 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER SELDEN Sole Member 860-449-0299 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CT PSY 2631) |
| Enumeration Date | 2010-04-08 |
| Last Update Date | 2010-04-08 |