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General NPI Number Information
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NPI Number | 1588228233
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Entity Type | Organization
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Legal Business Name | BEYOND WELLNESS LLC
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Dates
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Enumeration Date | 04/29/2019
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Last Update Date | 06/11/2019
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Provider Practice Location Address
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Address Line | 67 S COLONY ROAD
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City | WALLINGFORD
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State | CT
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Zip | 06492-4150
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Country | US
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Telephone | 203-626-1839
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Fax |
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Provider Business Mailing Address
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Address Line | 357 LONG HILL RD
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City | WALLINGFORD
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State | CT
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Zip | 06492-4912
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Country | US
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Telephone | 203-984-2264
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. ALEXANDRA ELIZABETH GREENFIELD
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Credential | LMFT
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Telephone | 203-626-1839
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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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