| NPI | 1720628969 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HECTOR G LIZCANO Sole Proprietorship/Psychotherapist 203-494-0333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2020-01-15 |
| Last Update Date | 2020-01-22 |