| NPI | 1730563016 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTEN N LARSON-SAMALUS Clinical Social Worker 860-455-3384 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CT 008567) |
| Enumeration Date | 2015-07-16 |
| Last Update Date | 2015-07-16 |