| NPI | 1760940175 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOAN ELISE FORBES Licensed Clinical Social Worker 860-717-2007 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2019-03-05 |
| Last Update Date | 2020-05-01 |