| NPI | 1790599280 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE WILSON-FANIEL Psychotherapist 860-461-9209 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103TC0700X Psychologist, Clinical | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2025-02-04 |
| Last Update Date | 2025-02-04 |