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Organization
MIND BODY MOTHERHOOD LLC
Active
Organization
MIND BODY MOTHERHOOD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMANTHA NILSSON LCSW (THERAPIST AND OWNER)
(860) 357-1734
Entity
Organization
Contact information
Practice address
649 AMITY RD STE 103, BETHANY, CT 06524-3091
(860) 357-1734
Mailing address
130 RICHARDSON DR, MIDDLEBURY, CT 06762-2124
(860) 357-1734
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
05/13/2020
Last updated
05/13/2020
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