| NPI | 1932480464 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BASSAM AWWA Owner 860-460-8461 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 1041C0700X Social Worker, Clinical | |
| 364SP0808X Clinical Nurse Specialist, Psych/Mental Health | |
| Enumeration Date | 2011-08-29 |
| Last Update Date | 2011-10-12 |