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General NPI Number Information
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NPI Number | 1043758006
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Entity Type | Organization
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Legal Business Name | HEALING WATERS, LLC
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Dates
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Enumeration Date | 02/09/2017
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Last Update Date | 02/09/2017
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Provider Practice Location Address
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Address Line | 7 WHISPERING PINE RD
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City | MONROE
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State | CT
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Zip | 06468-1430
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Country | US
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Telephone | 203-209-7174
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Fax | 203-502-1652
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Provider Business Mailing Address
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Address Line | 7 WHISPERING PINE RD
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City | MONROE
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State | CT
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Zip | 06468-1430
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Country | US
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Telephone |
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Fax | 203-502-1652
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Authorized Official
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Title or Position | OCCUPATIONAL THERAPIST
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Name | KARIN GUARIGLIA
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Credential | OTR/L
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Telephone | 203-209-7174
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 003910
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License Number State | CT
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