| NPI | 1750581765 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTHA JOAN GREEN Secty/Treas 860-635-4429 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: CT 000345) |
| Enumeration Date | 2007-07-19 |
| Last Update Date | 2007-07-19 |