| NPI | 1912434234 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI WAGNER Owner, Clinical Psychologist 203-494-8468 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CT 2706) |
| Enumeration Date | 2017-05-17 |
| Last Update Date | 2022-07-21 |