| NPI | 1881992626 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH C COLEMAN Supervising Psychologist 860-627-2271 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: CT 002217) |
| Enumeration Date | 2011-03-03 |
| Last Update Date | 2011-03-03 |