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General NPI Number Information
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NPI Number | 1821561234
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Entity Type | Organization
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Legal Business Name | PAT DEER LLC
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Dates
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Enumeration Date | 01/08/2019
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Last Update Date | 08/29/2024
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Provider Practice Location Address
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Address Line | 496 MAIN ST STE 3
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City | WINSTED
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State | CT
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Zip | 06098-1507
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Country | US
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Telephone | 203-770-5883
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Fax |
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Provider Business Mailing Address
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Address Line | 22 ALBOUGH RD
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City | BARKHAMSTED
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State | CT
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Zip | 06063-3370
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Country | US
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Telephone | 203-770-5883
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. PATRICIA E DEER
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Credential | LPC
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Telephone | 203-770-5883
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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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