| NPI | 1902574940 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI ANN PERRY Clinician 860-552-7811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2021-09-03 |
| Last Update Date | 2023-12-11 |