| NPI | 1669734604 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHELSEA HUMPHREY CEO 203-718-5926 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CA PSY23190) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: CA PSY23190) |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: CA PSY23190) | |
| 103TC0700X Psychologist, Clinical (Licence: CA PSY23190) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CA PSY23190) | |
| 103TF0000X Psychologist, Family (Licence: CA PSY23190) | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: CA PSY23190) | |
| Enumeration Date | 2012-06-14 |
| Last Update Date | 2025-04-18 |