Organization
FROM NOW BECOME, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOYOSORE PAUPAU MICKENS LCSW (OWNER)
(203) 496-2074
Entity
Organization
Contact information
Practice address
61 ROCK SPRING ROAD, #36, STAMFORD, CT 06906
(203) 496-2074
Mailing address
61 ROCK SPRING ROAD, #36, STAMFORD, CT 06906
(203) 496-2074
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
12/07/2020
Last updated
12/07/2020
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