| NPI | 1841522216 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PERRY A STALTARO President 860-502-4908 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| Enumeration Date | 2010-02-09 |
| Last Update Date | 2024-06-30 |