Organization
THE SACRED SELF, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLEEN K MIELE LPC (OWNER)
(860) 614-8382
Entity
Organization
Contact information
Practice address
171 MARKET SQ, SUITE 102, NEWINGTON, CT 06111-2927
(860) 614-8382
(860) 561-5394
Mailing address
171 MARKET SQ, SUITE 102, NEWINGTON, CT 06111-2927
(860) 614-8382
(860) 561-5394
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
002593
CT
Other
Enumeration date
09/15/2014
Last updated
09/15/2014
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