| NPI | 1740436344 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS JOSEPH MACIOLEK Licensed Psychologist 860-415-4551 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CT 001048) |
| Enumeration Date | 2008-08-14 |
| Last Update Date | 2015-11-20 |