| NPI | 1801332812 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW CLARK Owner / Professional Counselor 860-607-3235 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CT 002674) |
| Enumeration Date | 2017-01-13 |
| Last Update Date | 2017-01-13 |