NPI Profile for AUTHENTIC BALANCE CONSORTIUM LLC in CHAPLIN, CT.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Professional |
101YP2500X | |||
Clinical |
1041C0700X | 80 | Licensed Clinical Social Worker |
| NPI Number | 1538347349 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 02/04/2008 | |
| Last updated | 02/04/2008 - About 18 years ago | |
| Sole proprietor 1 | Not specified | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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