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General NPI Number Information
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NPI Number | 1316450653
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Entity Type | Organization
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Legal Business Name | TARYN ZARNETSKE LLC
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Dates
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Enumeration Date | 11/08/2017
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Last Update Date | 11/08/2017
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Provider Practice Location Address
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Address Line | 57 PLAINS RD STE 1E
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City | MILFORD
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State | CT
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Zip | 06461-2573
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Country | US
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Telephone | 203-767-5923
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Fax |
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Provider Business Mailing Address
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Address Line | 57 PLAINS RD STE 1E
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City | MILFORD
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State | CT
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Zip | 06461-2573
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Country | US
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Telephone | 203-767-5923
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TARYN ELIZABETH ZARNETSKE
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Credential | LCSW
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Telephone | 203-767-5923
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 007772
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number | 007772
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 007772
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License Number State | CT
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