| NPI | 1710312368 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY INGOLD Office Manager 860-969-1101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0802X Psychiatry & Neurology Addiction Psychiatry |
| Additional Taxonomies | 207RA0401X Internal Medicine Addiction Medicine |
| 106H00000X Marriage & Family Therapist | |
| 2084P0800X Psychiatry & Neurology Psychiatry | |
| 364SP0808X Clinical Nurse Specialist Psychiatric/Mental Health | |
| 2084A0401X Psychiatry & Neurology Addiction Medicine | |
| 363LA2200X Nurse Practitioner Adult Health | |
| 207QA0401X Family Medicine Addiction Medicine | |
| 291U00000X Clinical Medical Laboratory (Licence: CT CLPOL0509) | |
| Enumeration Date | 2013-09-13 |
| Last Update Date | 2017-04-19 |