| NPI | 1922578277 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE S GAUTHIER Manager 203-651-8809 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2018-11-29 |
| Last Update Date | 2021-01-26 |