| NPI | 1912409079 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARISSA R. RYAN Therapist 203-695-5914 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CT 0094588) |
| Enumeration Date | 2018-03-05 |
| Last Update Date | 2018-04-17 |