| NPI | 1851942403 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL ROACH Licensed Clinical Social Worker 860-574-3959 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2019-09-25 |
| Last Update Date | 2019-09-25 |