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General NPI Number Information
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NPI Number | 1548898802
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Entity Type | Organization
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Legal Business Name | CENTER FOR HEALING CONNECTIONS LLC
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Dates
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Enumeration Date | 03/31/2020
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Last Update Date | 03/31/2020
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Provider Practice Location Address
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Address Line | 130 WASHINGTON AVE
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City | NORTH HAVEN
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State | CT
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Zip | 06473-1709
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Country | US
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Telephone | 704-608-7941
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Fax |
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Provider Business Mailing Address
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Address Line | 30 N GOULD ST STE 11388
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City | SHERIDAN
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State | WY
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Zip | 82801-6317
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Country | US
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Telephone | 307-217-8052
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Fax |
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Authorized Official
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Title or Position | MEMBER/MANAGER
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Name | DR. TRACEY LASZLOFFY
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Credential | PHD, LMFT
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Telephone | 312-217-8024
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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 |
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License Number State |
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