| NPI | 1942965090 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAJAVON A DAVIS Co Owner/Clinical Director 860-759-5097 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Enumeration Date | 2021-11-03 |
| Last Update Date | 2021-11-03 |