| NPI | 1972093284 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA BURGESS Marriage And Family Therapist 860-470-6366 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CT 001978) |
| Enumeration Date | 2018-05-11 |
| Last Update Date | 2018-05-11 |