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General NPI Number Information
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NPI Number | 1487047817
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Entity Type | Organization
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Legal Business Name | THE AWAKENING CENTER, LLC
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Dates
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Enumeration Date | 03/10/2015
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Last Update Date | 03/10/2015
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Provider Practice Location Address
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Address Line | 2 CORPORATE DR STE 110
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City | TRUMBULL
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State | CT
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Zip | 06611-1376
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Country | US
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Telephone | 203-913-4376
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Fax |
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Provider Business Mailing Address
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Address Line | 10 CORWALL LANE
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City | TRUMBULL
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State | CT
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Zip | 06611
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEMBER/NATUROPATHIC PHYSICIAN
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Name | DR. ROBERT LEE
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Credential | ND, MS, MA
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Telephone | 203-913-4376
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number | 528
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License Number State | CT
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