| NPI | 1932680352 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TREVOR JOHNSON Manger 203-414-9306 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: GA csw005312) |
| Enumeration Date | 2018-08-23 |
| Last Update Date | 2018-08-23 |