| Neurodiverse Heart, Llc | |
|
16 Brace Rd West Hartford CT 06107-1825 | |
| (860) 479-1183 | |
| Not Available |
| Full Name | Neurodiverse Heart, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 16 Brace Rd, West Hartford, Connecticut |
| Authorized Official Name and Position | Kathleen W Johndrow (OWNER/CLINICIAN) |
| Authorized Official Contact | 8604791183 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Neurodiverse Heart, Llc 27 Gerthmere Dr West Hartford CT 06110-1619 Ph: (860) 965-9948 | Neurodiverse Heart, Llc 16 Brace Rd West Hartford CT 06107-1825 Ph: (860) 479-1183 |
| NPI Number | 1720781420 |
|---|---|
| Provider Enumeration Date | 03/23/2023 |
| Last Update Date | 03/23/2023 |
| Certification Date | 03/23/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720781420 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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