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General NPI Number Information
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NPI Number | 1851806434
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Entity Type | Organization
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Legal Business Name | JESSE TOTH, LLC
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Dates
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Enumeration Date | 12/05/2017
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Last Update Date | 10/14/2021
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Provider Practice Location Address
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Address Line | 847 W MAIN ST STE 3
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City | BRANFORD
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State | CT
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Zip | 06405-3456
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Country | US
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Telephone | 307-258-1326
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Fax |
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Provider Business Mailing Address
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Address Line | 32B MARLEN DR
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City | NORTH HAVEN
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State | CT
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Zip | 06473-2226
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Country | US
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Telephone | 307-258-1326
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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. JESSE JO TOTH-HENDERSON
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Credential | MA, RDT, LPC
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Telephone | 307-258-1326
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 2609
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License Number State | CT
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