| NPI | 1912641028 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON ANDRADE Licensed Clinical Social Worker 860-652-5260 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2022-04-25 |
| Last Update Date | 2022-04-25 |