| NPI | 1861911455 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARRISSA PHIPPS Licensed Psychologist 860-740-2041 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health |
| Additional Taxonomies | 101Y00000X Counselor |
| 103T00000X Psychologist | |
| Enumeration Date | 2017-09-14 |
| Last Update Date | 2022-01-13 |