| Lisa Shoglow, Llc | |
|
64 Old Hyde Rd Weston CT 06883-1726 | |
| (203) 810-8348 | |
| Not Available |
| Full Name | Lisa Shoglow, Llc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 64 Old Hyde Rd, Weston, Connecticut |
| Authorized Official Name and Position | Grace Cullen (MEDICAL BILLING MANAGER) |
| Authorized Official Contact | 2033685515 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lisa Shoglow, Llc 64 Old Hyde Rd Weston CT 06883-1726 Ph: (203) 810-8348 | Lisa Shoglow, Llc 64 Old Hyde Rd Weston CT 06883-1726 Ph: (203) 810-8348 |
| NPI Number | 1366908550 |
|---|---|
| Provider Enumeration Date | 02/13/2019 |
| Last Update Date | 02/13/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366908550 | NPI | - | NPPES |
| 004069985 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
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