Organization
OLD LYME COUNSELING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. HEATHER BONITZ MOORE MS, ATR-BC, LPC (PART OWNER)
(860) 617-4082
Entity
Organization
Contact information
Practice address
4 DAVIS RD W, SUITE 6, OLD LYME, CT 06371-4408
(860) 617-4082
Mailing address
19 BEECHWOOD BLVD, NORWICH, CT 06360-1405
(860) 617-4082
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
03/23/2010
Last updated
09/27/2010
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