| NPI | 1720572142 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARSHA ELAINE MAGUN Counselor 203-675-3739 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CT 000583) |
| Enumeration Date | 2018-06-19 |
| Last Update Date | 2024-01-25 |