| Mystic River Therapy Llc | |
|
112 New London Rd Groton CT 06340-4869 | |
| (860) 304-3503 | |
| Not Available |
| Full Name | Mystic River Therapy Llc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 112 New London Rd, Groton, Connecticut |
| Authorized Official Name and Position | Gabrielle Drugan (PROVIDING OWNER) |
| Authorized Official Contact | 8603043503 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mystic River Therapy Llc 141 Allen St Groton CT 06340-4055 Ph: (860) 304-3503 | Mystic River Therapy Llc 112 New London Rd Groton CT 06340-4869 Ph: (860) 304-3503 |
| NPI Number | 1972266591 |
|---|---|
| Provider Enumeration Date | 10/20/2021 |
| Last Update Date | 12/06/2021 |
| Certification Date | 12/06/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972266591 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
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