| NPI | 1851003958 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE MCNALLY Practice Manager 860-354-1596 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2022-12-20 |
| Last Update Date | 2022-12-20 |