| NPI | 1902539406 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAN FORD Nurse Practitioner Owner 860-625-8413 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2022-07-03 |
| Last Update Date | 2022-07-03 |