# MYSTIC RIVER THERAPY LLC

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

## Provider details

- **NPI number:** 1972266591
- **Authorized official:** GABRIELLE DRUGAN LMFT (PROVIDING OWNER)
- **Authorized official phone:** (860) 304-3503

## Contact information

- **Practice address:** 112 NEW LONDON RD, GROTON, CT 06340-4869
- **Practice address phone:** (860) 304-3503
- **Mailing address:** 141 ALLEN ST, GROTON, CT 06340-4055
- **Mailing address phone:** (860) 304-3503

## Taxonomy

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

## Other

- **Enumeration date:** 10/20/2021
- **Last updated:** 12/06/2021