| NPI | 1821607722 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEE WEBER Nurse Practitioner 860-852-1566 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2020-07-27 |
| Last Update Date | 2022-04-20 |