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General NPI Number Information
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NPI Number | 1770724379
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Entity Type | Organization
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Legal Business Name | A MINDFUL PATH, LLC
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Dates
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Enumeration Date | 03/12/2009
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Last Update Date | 08/06/2010
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Provider Practice Location Address
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Address Line | 1477 PARK STREET SUITE 14
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City | HARTFORD
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State | CT
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Zip | 06106
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Country | US
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Telephone | 860-402-9333
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Fax | 860-499-5477
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Provider Business Mailing Address
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Address Line | 1477 PARK STREET SUITE 14
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City | HARTFORD
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State | CT
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Zip | 06106
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Country | US
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Telephone | 860-402-9333
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Fax |
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Authorized Official
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Title or Position | BILLING SERVICE OWNER
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Name | MS. SUE TURGEON
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Credential |
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Telephone | 561-292-3126
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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 | 003729
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License Number State | CT
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