| NPI | 1871983239 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI PELOSI Owner 203-525-8052 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 005149) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 005149) |
| Enumeration Date | 2015-01-23 |
| Last Update Date | 2015-09-10 |