| NPI | 1760544720 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL HAYMES Psychologist 860-632-1296 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CT 749) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CT 749) |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| 103TF0200X Psychologist, Forensic | |
| 103TF0000X Psychologist, Family | |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2013-02-27 |