| NPI | 1932630886 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT PAUL OGURICK Licensed Professional Counselor 860-484-3712 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: CT 003063) |
| Enumeration Date | 2017-03-22 |
| Last Update Date | 2017-03-22 |