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General NPI Number Information
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NPI Number | 1972981314
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Entity Type | Organization
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Legal Business Name | CANDELA COUNSELING, LLC
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Dates
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Enumeration Date | 05/18/2015
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Last Update Date | 05/18/2015
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Provider Practice Location Address
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Address Line | 2911 DIXWELL AVE SUITE 104
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City | HAMDEN
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State | CT
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Zip | 06518-3195
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Country | US
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Telephone | 203-916-2488
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Fax |
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Provider Business Mailing Address
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Address Line | 2911 DIXWELL AVE SUITE 104
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City | HAMDEN
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State | CT
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Zip | 06518-3195
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Country | US
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Telephone | 203-916-2488
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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. TINA MARIE MEIN
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Credential | LMFT
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Telephone | 203-916-2488
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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 | 001540
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License Number State | CT
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