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Organization
IMAGE OF LIGHT MENTAL HEALTH SERVICES, LLC
Active
Organization
IMAGE OF LIGHT MENTAL HEALTH SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIRIAM HAYNES APRN (OWNER)
(860) 299-6677
Entity
Organization
Contact information
Practice address
45 S MAIN ST STE 70, WEST HARTFORD, CT 06107
(860) 299-6677
Mailing address
53 BURNWOOD DR, BLOOMFIELD, CT 06002-2235
(860) 299-6677
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
CT
Other
Enumeration date
04/03/2018
Last updated
07/09/2018
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