| NPI | 1932473527 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIJAH CALDWELL Executive Program Director 203-558-9865 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 251S00000X (Licence: CT 54084595001) |
| 363LF0000X Nurse Practitioner, Family (Licence: CT 5149) | |
| 2084D0003X Psychiatry & Neurology, Diagnostic Neuroimaging (Licence: CT 040650) | |
| Enumeration Date | 2012-02-29 |
| Last Update Date | 2016-11-22 |