Organization
LOTUS MOON COUNSELING CENTRE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WENDY ST. GEORGE LPC, BCPC (OWNER/COUNSELOR)
(860) 859-3341
Entity
Organization
Contact information
Practice address
148 ROUTE 2, PRESTON, CT 06365-8520
(860) 859-3341
(860) 760-6666
Mailing address
148 ROUTE 2, PRESTON, CT 06365-8520
(860) 859-3341
(860) 760-6666
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
001496
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004271144
—
CT
Enumeration date
11/08/2007
Last updated
11/08/2007
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