| NPI | 1871210252 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID L EZELL CEO 203-883-0464 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 103T00000X Psychologist |
| 1041C0700X Social Worker, Clinical | |
| 106H00000X Marriage & Family Therapist | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2022-10-26 |
| Last Update Date | 2022-10-26 |