| NPI | 1851880546 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WANDA IVELISSE RODRIGUEZ Billing Administrator 203-235-5767 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2018-05-08 |
| Last Update Date | 2025-02-24 |