| NPI | 1659768950 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHERINE I MCDERMOTT Owner 860-250-4522 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology |
| Enumeration Date | 2015-04-24 |
| Last Update Date | 2023-02-10 |