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General NPI Number Information
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NPI Number | 1205250586
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Entity Type | Organization
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Legal Business Name | DEBRA L. TOMASELLI, LMFT, LLC
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Dates
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Enumeration Date | 02/07/2014
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Last Update Date | 08/18/2014
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Provider Practice Location Address
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Address Line | 2296 MAIN STREET 2ND FLOOR
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City | STRATFORD
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State | CT
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Zip | 06615
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Country | US
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Telephone | 203-645-1677
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Fax | 203-377-4946
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Provider Business Mailing Address
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Address Line | 2296 MAIN STREET 2ND FLOOR
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City | STRATFORD
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State | CT
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Zip | 06615
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Country | US
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Telephone | 203-645-1677
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Fax | 203-377-4946
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Authorized Official
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Title or Position | MARRIAGE AND FAMILY THERAPIST
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Name | MRS. DEBRA L TOMASELLI
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Credential | LMFT
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Telephone | 203-645-1677
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 001558
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License Number State | CT
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