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General NPI Number Information
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NPI Number | 1548010721
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Entity Type | Organization
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Legal Business Name | FETTLE AND FLOURISHING HOLISTIC THERAPY, LLC
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Dates
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Enumeration Date | 03/22/2024
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Last Update Date | 03/22/2024
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Provider Practice Location Address
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Address Line | 414A LEBANON RD
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City | NORTH FRANKLIN
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State | CT
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Zip | 06254-1612
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Country | US
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Telephone | 860-830-1532
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Fax |
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Provider Business Mailing Address
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Address Line | 615 W JOHNSON AVE STE 202
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City | CHESHIRE
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State | CT
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Zip | 06410-4532
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Country | US
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Telephone | 860-830-1532
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MRS. LAURA CAROLINE DAWSON
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Credential | LCSW
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Telephone | 860-830-1532
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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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