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General NPI Number Information
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NPI Number | 1902364847
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Entity Type | Organization
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Legal Business Name | KATHRYN MCNEISH LMFT, LLC
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Dates
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Enumeration Date | 03/11/2019
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Last Update Date | 03/11/2019
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Provider Practice Location Address
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Address Line | 140 LAKE RIDGE RD
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City | SOUTHBURY
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State | CT
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Zip | 06488-4161
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Country | US
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Telephone | 203-900-7137
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Fax |
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Provider Business Mailing Address
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Address Line | 140 LAKE RIDGE RD
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City | SOUTHBURY
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State | CT
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Zip | 06488-4161
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Country | US
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Telephone | 203-900-7137
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Fax |
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Authorized Official
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Title or Position | MEDICAL BILLING MANAGER
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Name | GRACE CULLEN
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Credential |
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Telephone | 203-368-5515
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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