| NPI | 1871940189 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA BETH LANGWEIL Speech And Language Pathologist 860-604-8119 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: CT 002504) |
| Enumeration Date | 2016-05-17 |
| Last Update Date | 2016-05-17 |