| NPI | 1780318527 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KERRY LAW Provider 203-525-0995 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2022-07-15 |
| Last Update Date | 2024-04-24 |