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General NPI Number Information
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NPI Number | 1467069302
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Entity Type | Organization
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Legal Business Name | MORNING DEW THERAPY, LLC
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Dates
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Enumeration Date | 09/24/2020
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Last Update Date | 01/13/2023
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Provider Practice Location Address
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Address Line | 755 MAIN ST STE 1
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City | MONROE
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State | CT
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Zip | 06468-2830
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Country | US
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Telephone | 475-223-1996
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Fax |
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Provider Business Mailing Address
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Address Line | #1113 1201 KINGS HIGHWAY STE 2
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City | FAIRFIELD
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State | CT
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Zip | 06824
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Country | US
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Telephone | 475-223-1996
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Fax | 475-474-6129
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Authorized Official
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Title or Position | OWNER
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Name | MS. JESSICA DAVIS
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Credential | LPC
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Telephone | 475-223-1996
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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 |
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License Number State |
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