| NPI | 1780136655 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES P. LEMIEUX Member 475-888-9232 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CT 001375) |
| Enumeration Date | 2016-10-26 |
| Last Update Date | 2018-12-17 |