Organization
EMBRACE YOUR PATH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEBORAH SHILLINGFORD (OWNER/MANAGER)
(203) 520-9910
Entity
Organization
Contact information
Practice address
4270 MAIN ST, BRIDGEPORT, CT 06606-2306
(203) 301-8852
(203) 301-8852
Mailing address
39 COGSWELL ST, BRIDGEPORT, CT 06610-1913
(203) 520-9910
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
007937
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1497977375
BEHAVIORAL HEALTH
CT
Enumeration date
12/05/2017
Last updated
12/05/2017
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