| NPI | 1760844088 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOYCE A BELLAMY Officer 203-901-3491 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CT 008292) |
| Additional Taxonomies | 251S00000X (Licence: CT 008292) |
| Enumeration Date | 2016-03-25 |
| Last Update Date | 2016-03-25 |