Healthcare Provider Details

I. General information

NPI: 1821425778
Provider Name (Legal Business Name): SEX AND LOVE THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2013
Last Update Date: 10/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

998 FARMINGTON AVE SUITE 201
WEST HARTFORD CT
06107-2162
US

IV. Provider business mailing address

998 FARMINGTON AVE SUITE 201
WEST HARTFORD CT
06107-2162
US

V. Phone/Fax

Practice location:
  • Phone: 860-952-9070
  • Fax: 860-461-7761
Mailing address:
  • Phone: 860-952-9070
  • Fax: 860-461-7761

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number001617
License Number StateCT

VIII. Authorized Official

Name: MS. WENDY HAGGERTY
Title or Position: OWNER
Credential: M.S.M.F.T.
Phone: 860-952-9070