| NPI | 1710228036 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER ANN CLARK Clinical Program Director 860-917-0790 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CT 006060) |
| Enumeration Date | 2013-03-12 |
| Last Update Date | 2013-03-12 |