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General NPI Number Information
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NPI Number | 1629704259
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Entity Type | Organization
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Legal Business Name | ART THERAPY OF MILFORD, LLC
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Dates
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Enumeration Date | 07/26/2022
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Last Update Date | 07/26/2022
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Provider Practice Location Address
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Address Line | 16 DANIEL ST
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City | MILFORD
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State | CT
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Zip | 06460-3303
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Country | US
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Telephone | 203-623-7757
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Fax |
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Provider Business Mailing Address
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Address Line | 637 HIGH RIDGE RD
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City | ORANGE
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State | CT
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Zip | 06477-1530
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Country | US
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Telephone | 203-623-7757
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Fax |
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Authorized Official
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Title or Position | ART THERAPIST, LICENSED COUNSELOR
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Name | ERICA L HATRICK
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Credential | LPC, ATR, C-DBT
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Telephone | 203-623-7757
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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