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General NPI Number Information
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NPI Number | 1982963013
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Entity Type | Organization
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Legal Business Name | ZHUTA ENTERPRISES LTD LLC
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Dates
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Enumeration Date | 05/09/2012
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Last Update Date | 05/09/2012
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Provider Practice Location Address
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Address Line | 1177 HIGH RIDGE RD #120
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City | STAMFORD
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State | CT
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Zip | 06905-1221
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Country | US
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Telephone | 203-525-6496
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Fax |
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Provider Business Mailing Address
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Address Line | 8 WEAVER ST L1R
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City | GREENWICH
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State | CT
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Zip | 06831-5129
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Country | US
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Telephone | 203-525-6496
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Fax |
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Authorized Official
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Title or Position | CONTACT
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Name | MENDIM ZHUTA
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Credential | LMFT
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Telephone | 203-525-6496
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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 | 001321
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License Number State | CT
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