| NPI | 1851640163 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN ANDREW ROGALA Owner & Provider 203-308-8739 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CT 006512) |
| Additional Taxonomies | 104100000X Social Worker (Licence: CT 006512) |
| Enumeration Date | 2012-08-31 |
| Last Update Date | 2022-07-21 |