| NPI | 1871819631 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETTE J KOZAK Clinical Director 860-940-4838 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: CT 000562) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: CT 000562) |
| Enumeration Date | 2010-04-19 |
| Last Update Date | 2010-04-19 |