Organization
ADA THERAPY, LL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL WEISS PHD (CLINICAL PSYCHOLOGIST AND DIRECTOR)
(203) 540-5186
Entity
Organization
Contact information
Practice address
333 BENNETT ST, FAIRFIELD, CT 06825-1375
(203) 540-5186
Mailing address
333 BENNETT ST, FAIRFIELD, CT 06825-1375
(203) 540-5186
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
002750
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1083052468
—
CT
Enumeration date
05/06/2015
Last updated
05/06/2015
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