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53 Hawthorne Ave Waterbury CT 06708-4614 | |
| (475) 237-7058 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Counselor - Professional |
| Location | 53 Hawthorne Ave, Waterbury, Connecticut |
| Authorized Official Name and Position | Evan Hunter (OWNER) |
| Authorized Official Contact | 2033468277 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
53 Hawthorne Ave Waterbury CT 06708-4614 Ph: () - | 53 Hawthorne Ave Waterbury CT 06708-4614 Ph: (475) 237-7058 |
| NPI Number | 1558015685 |
|---|---|
| Provider Enumeration Date | 02/08/2022 |
| Last Update Date | 01/11/2025 |
| Certification Date | 01/11/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558015685 | NPI | - | NPPES |
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