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General NPI Number Information
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NPI Number | 1326484205
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Entity Type | Organization
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Legal Business Name | PM COUNSELING SERVICES, LLC
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Dates
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Enumeration Date | 05/17/2013
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Last Update Date | 05/17/2013
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Provider Practice Location Address
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Address Line | 447 GLENBROOK RD 2ND FLOOR
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City | STAMFORD
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State | CT
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Zip | 06906-1820
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Country | US
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Telephone | 203-356-0738
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Fax |
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Provider Business Mailing Address
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Address Line | 447 GLENBROOK RD 2ND FLOOR
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City | STAMFORD
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State | CT
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Zip | 06906-1820
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Country | US
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Telephone | 203-356-0738
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Fax |
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Authorized Official
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Title or Position | LICENSED MARRIAGE AND FAMILY THERAP
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Name | PAOLA MALLOZZI
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Credential | LMFT
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Telephone | 203-356-0738
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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 | CT000095
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License Number State | CT
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