Organization
WATERTOWN WELLNESS CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA ANNE MANDERINO LPC (OWNER/LICENSED PSYCHOTHERAPIST)
(203) 592-7898
Entity
Organization
Contact information
Practice address
116 GEORGETOWN DRIVE, WATERTOWN, CT 06795
(203) 592-7898
Mailing address
116 GEORGETOWN DR, WATERTOWN, CT 06795-3349
(203) 592-7898
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
003013
CT
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
04/17/2018
Last updated
04/17/2018
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