Organization
LOWER NAUGATUCK VALLEY PARENT CHILD RESOURCE CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL WYNNE (CHIEF EXECUTIVE OFFICER)
(203) 954-0543
Entity
Organization
Contact information
Practice address
30 ELIZABETH ST, 3RD FLOOR, DERBY, CT 06418-1802
(203) 954-0543
(203) 954-0544
Mailing address
30 ELIZABETH ST, 3RD FLOOR, DERBY, CT 06418-1802
(203) 954-0543
(203) 954-0544
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0PCC-9
CT
Other
Enumeration date
12/19/2005
Last updated
08/22/2020
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