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Organization
ELIZABETH DOMACK LLC
Active
Organization
ELIZABETH DOMACK LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH DOMACK LPC (OWNER)
(860) 309-8334
Entity
Organization
Contact information
Practice address
57 PLAINS RD STE 3C, MILFORD, CT 06461-2573
(860) 309-8334
Mailing address
18 RIMMON RD, WOODBRIDGE, CT 06525-2002
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1225405152
—
CT
Enumeration date
10/01/2019
Last updated
10/01/2019
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