| NPI | 1710631858 |
|---|---|
| Former Legal Business Name | NEW MOON BEHAVIORAL HEALTH AND WELLNESS, PLLC |
| Entity Type | Organization |
| Authorized Contact | JESSICA BOLAND Owner 860-874-7261 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2022-02-08 |
| Last Update Date | 2023-01-13 |