| NPI | 1740648286 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHRYN L MCGIBBON Owner 475-434-8744 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: CT 008734) |
| Enumeration Date | 2016-01-28 |
| Last Update Date | 2016-01-28 |