| NPI | 1750816120 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY BANKS Owner/Clinician 860-841-6574 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CT 001450) |
| Enumeration Date | 2017-04-24 |
| Last Update Date | 2017-04-24 |