Organization
WAVERLY GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAUREN ZALIS OTR/L (MEMBER/MANAGING DIRECTOR)
(203) 622-8600
Entity
Organization
Contact information
Practice address
100 MELROSE AVE, SUITE 100, GREENWICH, CT 06830-6257
(203) 622-8600
(203) 622-1760
Mailing address
100 MELROSE AVE, SUITE 100, GREENWICH, CT 06830-6257
(203) 622-8600
(203) 622-1760
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
001840
CT
225XP0200X
Pediatric Occupational Therapist
Primary
003422
CT
Other
Enumeration date
11/09/2011
Last updated
11/09/2011
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