| NPI | 1821171117 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID EDWARD PAVLICK Owner 860-567-0852 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CT 3901) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2015-04-22 |