# INNERLIGHT WELLNESS COUNSELING PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043094956
- **Authorized official:** MANDY L TIEDEMAN LMFT (MEMBER)
- **Authorized official phone:** (860) 918-7946

## Contact information

- **Practice address:** 119C GRISWOLD ST STE 202, GLASTONBURY, CT 06033-1099
- **Practice address phone:** (860) 918-7946
- **Practice address fax:** (860) 735-5842
- **Mailing address:** 119C GRISWOLD ST STE 202, GLASTONBURY, CT 06033-1099
- **Mailing address phone:** (860) 918-7946

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | — | NULL | Yes |
| 106H00000X | Marriage & Family Therapist | — | — | Yes |

## Other

- **Enumeration date:** 08/22/2023
- **Last updated:** 08/22/2023