| NPI | 1982286431 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON K. ROUSE Owner 203-554-4054 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional |
| Additional Taxonomies | 104100000X Social Worker |
| 106H00000X Marriage & Family Therapist | |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2021-04-24 |
| Last Update Date | 2024-06-04 |