| Requa Psychotherapy Llc | |
|
72 Park St Suite 103 New Canaan CT 06840-4532 | |
| (203) 803-0469 | |
| Not Available |
| Full Name | Requa Psychotherapy Llc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 72 Park St, New Canaan, Connecticut |
| Authorized Official Name and Position | Sara S Requa (OWNER/THERAPIST) |
| Authorized Official Contact | 2038030469 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Requa Psychotherapy Llc Po Box 1007 Southbury CT 06488-4107 Ph: (203) 803-0469 | Requa Psychotherapy Llc 72 Park St Suite 103 New Canaan CT 06840-4532 Ph: (203) 803-0469 |
| NPI Number | 1124366745 |
|---|---|
| Provider Enumeration Date | 01/17/2013 |
| Last Update Date | 01/17/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124366745 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | 001415 (Connecticut) | Primary |
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