| NPI | 1841770237 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONYA CASSELL Billing Administrator 860-405-4951 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: RI ISW02792) |
| Enumeration Date | 2018-08-15 |
| Last Update Date | 2018-08-15 |