| NPI | 1881108496 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL OTOOLE Owner 203-515-8185 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: CT 007178) |
| Enumeration Date | 2017-11-20 |
| Last Update Date | 2017-11-20 |