| NPI | 1902173370 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MALY PHIMVONGSA Director 860-254-5127 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: CT 001470) |
| Enumeration Date | 2011-11-29 |
| Last Update Date | 2020-02-11 |