| Divine Resilience Llc | |
|
2389 Main St Ste 100 Glastonbury CT 06033-4617 | |
| (203) 361-6038 | |
| Not Available |
| Full Name | Divine Resilience Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 2389 Main St Ste 100, Glastonbury, Connecticut |
| Authorized Official Name and Position | Natalie Wisdom (PROVIDER/OWNER) |
| Authorized Official Contact | 2033616038 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Divine Resilience Llc 95 Prospect Rd East Haven CT 06512-3304 Ph: () - | Divine Resilience Llc 2389 Main St Ste 100 Glastonbury CT 06033-4617 Ph: (203) 361-6038 |
| NPI Number | 1548966880 |
|---|---|
| Provider Enumeration Date | 02/07/2023 |
| Last Update Date | 10/10/2023 |
| Certification Date | 10/10/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548966880 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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