| NPI | 1679348940 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA BORELLI DONCKELS Clinical Director 203-887-8857 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2023-11-16 |
| Last Update Date | 2023-11-16 |