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Organization
COLLABORATIVE CANCER CARE
Active
Organization
COLLABORATIVE CANCER CARE
Active
Other names
Collaborative Cancer Care
Organization subpart
No
Provider details
NPI number
Authorized official
WENDY GARVIN APRN (NURSE PRACTITIONER)
(617) 650-3391
Entity
Organization
Contact information
Practice address
112 SPENCER ST STE 2, MANCHESTER, CT 06040-4601
(860) 245-8853
Mailing address
8 BIRCHWOOD RD, EAST HARTFORD, CT 06118-1702
(617) 650-3391
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
NULL
101YM0800X
Mental Health Counselor
—
—
106H00000X
Marriage & Family Therapist
—
NULL
106H00000X
Marriage & Family Therapist
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
NULL
363LA2200X
Adult Health Nurse Practitioner
Primary
—
NULL
363LA2200X
Adult Health Nurse Practitioner
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
01/10/2024
Last updated
05/22/2024
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