| NPI | 1821892191 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MALLORY ALEXIS FREEMAN Ap RN 203-212-7592 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2025-04-03 |
| Last Update Date | 2025-10-15 |