| NPI | 1992983027 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY WARREN BLOOM Licensed Clinical Social Worker 203-451-1599 |
| Organization Subpart ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: CT 005722) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 034343) |
| Enumeration Date | 2008-01-31 |
| Last Update Date | 2009-09-08 |