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General NPI Number Information
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NPI Number | 1356010227
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Entity Type | Organization
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Legal Business Name | NIA THERAPY NOOK LLC
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Dates
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Enumeration Date | 09/13/2021
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Last Update Date | 09/13/2021
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Provider Practice Location Address
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Address Line | 19 WONDY WAY
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City | DANBURY
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State | CT
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Zip | 06811-3856
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Country | US
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Telephone | 203-645-2910
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1010
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City | DANBURY
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State | CT
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Zip | 06813-1010
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Country | US
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Telephone | 203-645-2910
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Fax |
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Authorized Official
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Title or Position | OWNER/CLINICIAN
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Name | NAKIAA MILLER
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Credential | LCSW
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Telephone | 203-645-2910
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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