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General NPI Number Information
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NPI Number | 1609564483
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Entity Type | Organization
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Legal Business Name | MBS WELLNESS
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Dates
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Enumeration Date | 04/28/2023
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Last Update Date | 04/28/2023
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Provider Practice Location Address
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Address Line | 26 FENWAY RD
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City | BRANFORD
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State | CT
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Zip | 06405-5007
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Country | US
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Telephone | 203-376-6404
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Fax |
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Provider Business Mailing Address
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Address Line | 26 FENWAY RD
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City | BRANFORD
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State | CT
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Zip | 06405-5007
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Country | US
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Telephone | 203-376-6404
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Fax |
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Authorized Official
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Title or Position | LCSW
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Name | MRS. MADELINE PEREZ-CATANIA
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Credential |
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Telephone | 120-337-6640
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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