| Bourgeois Llc | |
|
43 Sherman Hill Rd Cornerstone Professional Park, Building D Woodbury CT 06798-3651 | |
| (203) 770-1414 | |
| Not Available |
| Full Name | Bourgeois Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 43 Sherman Hill Rd, Woodbury, Connecticut |
| Authorized Official Name and Position | Barbara L Bourgeois (OWNER) |
| Authorized Official Contact | 2037701414 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bourgeois Llc 270 Main St S Woodbury CT 06798-3407 Ph: (203) 725-5042 | Bourgeois Llc 43 Sherman Hill Rd Cornerstone Professional Park, Building D Woodbury CT 06798-3651 Ph: (203) 770-1414 |
| NPI Number | 1265846778 |
|---|---|
| Provider Enumeration Date | 06/12/2014 |
| Last Update Date | 06/12/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265846778 | NPI | - | NPPES |
| 00805070702 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 002514 (Connecticut) | Primary |
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