Organization
MACHARIA PSYCHOTHERAPY SERVICCES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRACE CULLEN (MEDICAL BILLING MANAGER)
(203) 368-5515
Entity
Organization
Contact information
Practice address
59 KENT ST, MILFORD, CT 06461-2949
(203) 446-1848
Mailing address
59 KENT ST, MILFORD, CT 06461-2949
(203) 446-1848
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004069985
—
CT
Enumeration date
12/11/2018
Last updated
12/11/2018
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