| NPI | 1770303018 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEON SEBASTIAN MILARDO Owner 860-894-9059 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-10-11 |
| Last Update Date | 2025-12-05 |