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Organization
MIND BODY RISE
Active
Organization
MIND BODY RISE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRI FOGG DONOVAN (OWNER)
(860) 912-9584
Entity
Organization
Contact information
Practice address
808 STONINGTON RD STE 200, STONINGTON, CT 06378-2517
(860) 535-9922
Mailing address
808 STONINGTON RD, STONINGTON, CT 06378-2530
(860) 535-9922
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
05/25/2021
Last updated
07/01/2025
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