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General NPI Number Information
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NPI Number | 1356845093
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Entity Type | Organization
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Legal Business Name | FAMILY THERAPY SERVICES LLC
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Dates
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Enumeration Date | 03/19/2018
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Last Update Date | 04/02/2019
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Provider Practice Location Address
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Address Line | 151 NEW PARK AVE SUITE D
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City | HARTFORD
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State | CT
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Zip | 06106
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Country | US
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Telephone | 860-922-8908
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Fax |
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Provider Business Mailing Address
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Address Line | 151 NEW PARK AVE SUITE D
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City | HARTFORD
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State | CT
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Zip | 06106
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Country | US
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Telephone | 860-922-8908
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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 | ANGELES RAMOS
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Credential | LMFT
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Telephone | 860-922-8908
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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 | 1661
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License Number State | CT
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