Organization
GANIKA THERAPY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KATHLEEN DOUGLAS (LCSW)
(860) 333-1388
Entity
Organization
Contact information
Practice address
44R LEBANON RD, BOZRAH, CT 06334-1148
(860) 333-1388
(710) 456-3471
Mailing address
44R LEBANON RD, BOZRAH, CT 06334-1148
(860) 333-1388
(710) 456-3471
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
006591
CT
Other
Enumeration date
06/28/2012
Last updated
06/28/2012
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