| Into The Woods Llc | |
|
760 Bantam Rd Bantam CT 06750-1603 | |
| (860) 412-4547 | |
| Not Available |
| Full Name | Into The Woods Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 760 Bantam Rd, Bantam, Connecticut |
| Authorized Official Name and Position | Krystle Sullivan (CLINICIAN) |
| Authorized Official Contact | 8604124547 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Into The Woods Llc 760 Bantam Rd Bantam CT 06750-1603 Ph: () - | Into The Woods Llc 760 Bantam Rd Bantam CT 06750-1603 Ph: (860) 412-4547 |
| NPI Number | 1295200608 |
|---|---|
| Provider Enumeration Date | 10/11/2018 |
| Last Update Date | 10/11/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295200608 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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